【摘要】 目的:分析再发性心肌梗死的相关危险因素。方法:选择2000-05/2004-10阜新地区阜新市中心医院、阜新市第二人民医院、阜新矿务局总医院心内科住院的再发性心肌梗死患者47例为再发性心肌梗死组,男33例,女14例。选择同期在3家医院住院确诊为急性首发心肌梗死患者271例为对照组,男169例,女102例。两组患者均知情同意,并分别接受了下面内容调查和检测:①心血管病危险因素调查表(包括吸烟、饮食习惯、生活方式、是否参加体育锻炼、血糖、血脂等)。②症状自评量表,分值越高,代表精神状况越差。③生活事件量表中生活事件精神紧张值评分越高,遭遇负性生活事件越多,精神状况越差。④生物学和血生化指标检查。结果:按意向处理分析,进入结果分析再发性心肌梗死和急性心肌梗死患者分别为47和271例。①再发心肌梗死组的平均年龄、吸烟指数、未参加体育锻炼例数、平均症状自评量表总分和遭遇生活事件精神紧张值平均值均明显高于对照组犤(59±15)岁,(36.3±13.4)年支,68.1%(32/47),166.4±44.8,18.6±5.2;(56±11)岁,(25.0±9.3)年支,50.9%(138/271),141.6±39.6,10.2±3.3,t=2.249～4.131,χ2=4.092～4.550,P<0.05～0.01犦。②再发性心肌梗死组的平均收缩压、平均舒张压、体质量指数、平均静息心率、空腹血糖、总胆固醇和三酰甘油浓度均明显高于对照组(t=2.147～3.383,P<0.05～0.01),高密度脂蛋白胆固醇浓度明显低于对照组(t=3.126,P<0.01)。结论:首发性心肌梗死后行为因素及遭遇均为再发的危险因子,具有多项高危因子累积者是再发性心肌梗死的主要危险人群。更多还原

【Abstract】 AIM:To analyze the risk factors related to recurrent acute myocardial in-farction.METHODS:From May 2000to October 2004,47patients with recurrent acute myocardial infar ction(recurrent acute myocardial infarction group,33males and 14females) ,who were hospitalized in the cardio logical depart-ments of Fuxin Central Hos pital,Fuxin Second People’ s Hospital,General Hospital of Fuxin Bureau of Mine ,and271patients with acute myocardial infarction(control group,169males and 102fema les),who were diagnosed in the three hospitals,participated i n the study voluntarily.All the pati ents re-ceived the following survey and dete rmination:①cardiovascular risk factor inventory,including smoking,dieta ry habit,living style,participating exercise or not,blood glucose and blood l ip;②symptom checklist-90:the higher th e scores,the worse the mental stat us;③life events scale:the higher the score of psychentonia,the more the nega ti ve life events he met,and the worse th e mental status;④examinations of bi ological and bloo d biochemical indexes.RESULTS:According to intention-to-tr eat an alysis,47patients with recur-rent acute myocardial infarction an d 2 71patients with acute myocardial in-farction were involved in the analysis o f results.①The mean age,smoking index,number of case that did not participat e in exercise,average total score of symptom checklist-90and average score o f psychentonia for life event s were obviously higher in the recurre nt acute my ocardial infarction grou p(59±15)years old,(36.3±13.4)year ·piece,68.1%(32/47),166.4±44.8,18.6±5.2than in the control group(56±11)years old,(25.0±9.3)year·piece, 50.9%(138/271),141.6±39.6,10.2±3.3(t=2. 249to 4.131,χ 2 =4.092to 4.550,P<0.05to 0.01).②The mean systolic pre ssure,mean diasto lic pressure,body mass index,mean resting heart rate,fasti ng blood gl ucose,total cholesterol and tracyl glycerol concentrations in the r ecurrent acu te myocardial infarction group were markedly higher than those in t he con trol group(t=2.147to 3.383,P<0.05to 0.01),and the concentration of high density lipoprotein cholesterol was obviously lower than that in the c ontrol group(t=3.126,P<0.01).CONCLUSION:Both behav ioral factors and encount ers after primary acute myocardial infarction are the risk f actors for the reoccurrence,and the pa-tients with the accumulation of multiple high risk factors are the main risk crowds of recurrent acute myocardia l infarction.更多还原