【摘要】 目的:探讨急性心肌梗死(心梗)患者室壁瘤形成的危险因素。方法:将我院2012-04至2014-07期间急性心梗行经皮冠状动脉介入治疗术资料完整的288例患者按照是否发生室壁瘤分为室壁瘤组146例和非室壁瘤组142例,从年龄、性别、高血压、高脂血症、糖尿病、吸烟、家族史、心梗史、前壁心梗、心绞痛发作、左主干病变、前降支近段病变、纽约心脏协会(NYHA)心功能Ⅲ/Ⅳ级、胸痛时间≥24 h、≥4个相邻导联ST段抬高等结果方面对室壁瘤形成的危险因素进行回顾性分析。结果:室壁瘤组患者的年龄(OR=1.023,95%CI:1.000~1.046)、吸烟(OR=1.819,95%CI:1.130~2.928)、前壁心梗(OR=9.162,95%CI:4.657~18.028)、≥4个相邻导联ST段抬高(OR=6.571,95%CI:2.426~17.798)发生比例显著高于非室壁瘤组(P均<0.05),而室壁瘤组心绞痛发作(OR=0.557,95%CI:0.335~0.927)低于非室壁瘤组。经多因素Logistic回归分析,并调整年龄、性别、高血压、糖尿病和心绞痛发作影响后,结果显示吸烟(回归系数:0.833,OR=2.301,95%CI:1.283~4.125),前壁心梗(回归系数:1.799,OR=6.041,95%CI:2.831~12.894)与室壁瘤事件呈正相关。结论:吸烟与前壁急性心梗是急性心梗后室壁瘤发生的危险因素,且前壁急性心梗是室壁瘤发生的强相关因素。更多还原

【Abstract】 Objective:To explore the risk factors for ventricular aneurysm formation in patients after acute myocardial infarction(AMI).Methods:Our research included 2 groups of AMI patients who received percutaneous coronary intervention(PCI)in our hospital from 2012-04 to 2014-07 as Ventricular aneurysm group,n=146 and Control group,n=142,in which the AMI patients without ventricular aneurysm formation.The baseline condition with aneurysm related risk factors were analyzed and compared between 2 groups including age,gender,hypertension,hyperlipidaemia,diabetes,smoking,family history,MI history,anterior myocardial wall infarction,angina pectoris,left main(LM) disease,the lesion at proximal left anterior descending(LAD) artery,NYHA classification Ⅲ/Ⅳ,chest pain time > 24 hours and ST-segment elevation > 4 adjacent leads in ECG.Results:Compared with Control group,the patients in Ventricular aneurysm group had the elder age(OR=1.023,95%CI 1.000-1.046),higher incidence rates of smoking(OR=1.819,95%CI 1.130-2.928) and anterior MI(OR=9.162,95%CI4.657-18.028),more patients with > 4 adjacent ST-segment elevation(OR=6.571,95%CI 2.426-17.798),while less patients with angina pectoris(OR=0.557,95%CI 0.335-0.927,all P<0.05.With adjusted relating factors of age,gender,hypertension,diabetes and angina pectoris,the multivariate Logistic regression analysis indicated that smoking(regression coefficient:0.833,OR=2.301,95%CI 1.283-4.125),anterior MI(regression coefficient:1.799,OR=6.041,95%CI 2.831-12.894)were positively related to ventricular aneurysm formation.Conclusion:Smoking and anterior MI were strongly related to ventricular aneurysm formation in patients after AMI.更多还原