【摘要】 目的 探讨该院2014年1月1日-2018年12月31日急性心肌梗死患者院内死亡的影响因素，可为切实减少该类疾病院内死亡起到积极的指导作用。方法 收集西北某三级综合医院2014年1月1日-2018年12月31日急性心肌梗死1864例患者住院信息，对比存活与死亡患者在基本情况、临床特征、治疗及用药方面的数据，对发生院内死亡的危险因素进行COX比例风险回归分析。结果 该院急性心肌梗死患者共计1864例，其中死亡54例，院内死亡率为2.90%。年龄因素的相对危险度为(RR=1.509,95%CI1.145-1.989,P=0.003)、有室性心动过速患者的相对危险度为(RR=2.743,95%CI 1.078-6.980,P=0.034)、入院时Killip分级的相对危险度为(RR=2.196,95%CI1.694-2.846,P<0.001)和行主动脉球囊反博术患者的相对危险度为(RR=2.669,95%CI 1.366-5.213,P=0.004)、医疗付款方式的相对危险度为(RR=3.309,95%CI 1.658-6.607,P=0.001)、行经皮冠状动脉支架植入术(RR=0.297,95%CI 0.149-0.594,P=0.001)、使用阿司匹林(RR=0.248,95%CI0.083-0.738,P=0.012)。结论 年龄、室性心动过速、入院时Killip分级和主动脉球囊反博术、自费是急性心肌梗死患者发生院内死亡的危险因素，同时行经皮冠状动脉支架植入术、使用阿司匹林被认为是该院急性心肌梗死住院患者院内死亡的保护因素。更多还原

【Abstract】 Objective To explore the influencing factors of hospital death of AMI patients from January 1, 2014 to December 31, 2018 in the hospital, and to play an active guiding role in reducing the hospital death of this kind of disease. Methods The hospitalization data of discharged patients with acute myocardial infarction from 2014 to 2018 in a tertiary general hospital in Northwest China were collected, and the data of basic conditions, clinical characteristics, treatment and medication of the surviving and dead patients were compared. COX regression analysis was carried out on the risk factors of hospital death. Results There were 1864 patients with acute myocardial infarction in our hospital, of which 54 died, and the in-hospital mortality rate was 2.90%. From 2014 to 2018, the hospital age(RR=1.509, 95%CI 1.145-1.989, P=0.003), ventricular tachycardia(RR=2.743, 95%CI 1.078-6.980, P=0.034), and the patients were Killip on admission P < 0.001), aortic balloon pump(RR=2.669, 95%CI 1.366-5.213, P=0.004) and medical payment(RR=3.309, 95%CI 1.658-6.607,P=0.001) P=0.001), aspirin use is(RR=0.248, 95%CI 0.083-0.738, P=0.012). Conclusion age, ventricular tachycardia, Killip grade at admission, aortic balloon counterpulsation and self-expense are the risk factors of hospital death in patients with acute myocardial infarction, and percutaneous coronary stent implantation and aspirin use are considered as the risk factors.更多还原