Correlation between H-type hypertension and short-term prognosis in patients with first onset acute myocardial infarction
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摘要:目的 探讨H型高血压与初发急性心肌梗死(AMI)患者近期预后的关系。方法 选取本院收治的发病24 h内初发急性心肌梗死合并高血压患者316例, 根据血浆同型半胱氨酸(Hcy)水平将其分为H型高血压组(Hcy≥10 μmol/L)176例与对照组(Hcy < 10 μmol/L)140例，收集患者病史、化验检查、心脏彩超、冠状动脉造影结果等住院资料，分析2组患者住院期间不良心血管事件的发生情况。结果 2组充血性心力衰竭、心源性休克、死亡、心脏破裂和联合事件的发生率差异均有统计学意义(P < 0.01); Logistic回归分析结果显示, H型高血压是初发急性心肌梗死预后的不良危险因素。结论 H型高血压是初发急性心肌梗死患者近期预后的独立危险因素。Abstract:Objective To exploreCorrelation between H-type hypertension and short-term prognosis in patients with first onset acute myocardial infarction(AMI).Methods A total of 316 first onset acute myocardial infarction complicated with hypertension within 24 hours in our hospital were selected, and were divided into H-type hypertension group(Hcy≥10 μmol/L, n=176) and control group(Hcy < 10 μmol/L, n=140). All the patient's hospitalization information such as past history, laboratory examination, cardiac ultrasound and coronary angiography were collected. The occurrence of cardiac events between two groups were observed.Results The incidence of congestive heart failure, cardiogenic shock, death, cardiac rupture, and joint adverse events showed statistically significant difference(P < 0.01). Logistic regression analysis showed that H-type hypertension was an independent risk factor in patients with acute myocardial infarction.Conclusion H-type hypertension is an important predictor for short-term prognosis in patients with first onset myocardial infarction.
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Keywords:
- hypertension /
- homocysteine /
- acute myocardial infarction /
- heart failure /
- cardiac rupture
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表 1 2组患者的基线资料比较(x±s)[n(%)]
组别 n 男 女 年龄/岁 吸烟 糖尿病 高脂血症 收缩压/mmHg H型高血压组 176 94 82 63.00±6.00 89(50.57) 23(30.67) 108(61.36) 155.00±30.00 对照组 140 79 61 63.00±9.00 72(51.42) 51(36.43) 76(54.29) 148.00±25.00 
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表 2 2组患者实验室指标水平比较(x±s)
组别 n 甘油三酯/ (mmol/L) 总胆固醇/ (mmol/L) 低密度脂蛋白/ (mmol/L) 血糖/ (mmol/L) D-二聚体/ (μg/L) CRP/ (mg/L) H型高血压组 176 2.10±0.50 6.20±1.60 4.10±1.30 7.40±3.00 5.34±0.90 16.40±2.90 对照组 140 1.90±0.60 6.40±0.90 3.90±1.70 7.50±2.40 5.10±0.60 14.50±2.50
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表 3 2组患者近期心血管事件发生情况比较[n(%)]
组别 充血性心力衰竭 恶性心律失常 心源性休克 心脏破裂 死亡 联合事件 H型高血压组(n=176) 67(38.07)* 41(23.30)* 13(7.39)* 14(7.39)* 27(15.34)* 39(22.16)* 对照组(n=140) 29(20.71) 18(12.86) 3(2.14) 3(2.14) 7(5.00) 15(10.71) 与对照组比较, *P < 0.05。
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表 4 H型高血压与初发AMI患者近期预后的Logistic回归分析
心血管事件 回归系数 OR 95%可信区间 P值 充血性心力衰竭 0.094 1.096 1.041~1.174 0.001 恶性心律失常 0.201 2.447 1.878~5.247 0.027 心源性休克 0.081 1.894 1.029~1.143 0.002 心脏破裂 0，057 1.105 1.003~1.122 0.018 死亡 0.064 1.065 1.006~1.134 0.026 联合事件 0.082 1.084 1.014~1.165 0.027
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