【摘要】 目的探讨急性心肌梗死不同中医证型对住院预后的影响。方法 142例急性心肌梗死患者分为痰浊闭塞、气滞血瘀、气阴两虚、阳气亏虚4组,比较其临床特征、住院治疗经过和主要心脏事件及死亡的发生率,对影响住院死亡进行多因素logistic回归分析。结果四组患者在性别、吸烟、血肌酐及早期再灌注等差异无统计学意义(P>0.05);气滞血瘀组恶性心律失常的发生率(58.7%)最高;四组中心力衰竭的发生率阳气亏虚组中较高(63.6%),但差异无统计学意义;阳气亏虚组住院死亡率较其他组明显升高(P<0.05),多因素Logistic回归分析显示中医辨证分型不是影响住院死亡的独立危险因素。结论气滞血瘀型易发生心律失常,阳气亏虚患者住院期间死亡的风险较高,中医证型对判断急性心肌梗死患者的住院预后有一定指导意义。更多还原

【Abstract】 Objective To evaluate the impact of Chinese medical syndrome on in-hospital outcomes in patients with acute myocardial infarction(AMI).Methods The data of 142 patients hospitalized with AMI were collected from the database of Fujian provincial people’s hospital between June 2009 and May 2012.The patients were categorized into 4 groups according to chinese medical syndrome.Clinical characteristics,therapeutic approaches and the incidence of heart failure,malignant arrhythmias,and death during hospitalization were compared.A multivariate logistic regression analysis was performed to examine association between candidate risk factors and in-hospital outcomes.Results Gender,history of smoke,serum creatinine and early revascularization therapy were insignificantly different across patient groups.The incidence of malignant arrhythmias in the group of qi stagnation and blood stasis was highest among four groups.In-hospital Mortality and the incidence of heart failure in yang-qi deficiency group were higher than any other group.After multivariate adjustment,chinese medical syndrome was not associated with a graded increase of in-hospital death in patients with AMI.Conclusion AMI patients with qi stagnation and blood stasis tend to develope malignant arrhythmias.Yang-qi deficiency patients are at higher risk of death during hospitalization.Chinese medical syndrome is of certain value in predicting in-hospital outcomes in AMI patients.更多还原