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急性心肌梗死并心房纤颤的危险因子及预后(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2001年第2期
页码:
128-129，132
栏目:
论著
出版日期:
2001-03-01

文章信息/Info

Title:
Risk factors and prognostic significance of atrial fibrillation complicated by acute myocardial infarction
作者:
高友山1 ; 钱学贤1 ; 马大波2
1．第一军医大学珠江医院心内科，广东广州510282；2．广州军区武汉总医院心内科
Author(s):
GA0 You-shan1 ; QIAN Xue-xian1 ; MA Da-bo2
1．Department of Cardiology，Zhujiang Hospital，First Military Medical University,Guangzhou Guangdong 510282，China; 2．Department of Cardiology,Wuhan General Hospital of Guangzhou Command of PAL
关键词:
心肌梗塞; 心房颤动
Keywords:
myocardial infarction; atrial fibrillation
分类号:
R542.22
DOI:
-
文献标识码:
A
摘要:
目的 探讨急性心肌梗死(AMI)并发心房纤颤(房颤)的危险因子及房颤对AMI预后的影响．方法 比较412例AMI患者中并发房颤者与不并发房颤者的临床特征、住院其它并发症以及住院病死率。结果 并发房颤组较不并发房颤组年龄大，肌酸磷酸激酶(CPK)峰值高，左房内径大，入院时心功能差、但Logistic回归分析仅显示CPK峰值、左房内径相差明显、并发房颤者病死率较无房颤者高，校正其它因素后仍明显。结论 AMI并房颤者CPK峰值高、左房内径大，住院病死率高，对该亚组应更积极的治疗。
Abstract:
AIM To investigate the risk factors and prognostic significance of atrial fibrillation following acute myocardial infarctlon (AMI)．METHODS Among 412 AMI patients，the clinical feature，other complications and in-hospital mortality rate were compared between patients with and without atria1 fibrillation． RESULTS Compared with those without atrial fibrillation，the AMI patients with atrial fibrillation were older,had a higher peak of creatine kinase level，larger left atria1 size,worse cardiac function．But logistic analysis indicated that differences existed only in peak creatine kinase level and left atrial size between the two groups．Patients with atrial fibrillation had a higher in-hospital mortality rate than those without atrial fibrillation，and this rate remained signillcant after other risk factors were corrected．CONCLUSION AMI patients with atrial fibrillation had a higher creatine kinase level，larger left atrial size and higher in-hospital mortality rate，so these patients should receive more intensive care.

参考文献/References

[1]Klass M，Haywood LJ，Angeles L. Atrial fibrillation associated with acute myocardial infarction:a study of 34 cases[J]．Am Heart J，1970，79(4):752．

[2]Eldar M,Caaetti M，Ratstein Z,et a1. Significance of paroxysmal atrial fibrillation complicting acute myocardial infarction in the thrombolytic era[J]．Circulation．1998,97(10):965．

[3]Crenshaw BS,Ward SR，Granger CB，et a1．Atrial fibrillation in the setting of acute myocardial infarction,The GUSTO-1 experience[J].JACC,1997，30(2)：406．

[4]Goldberg RJ,Seeley D,Backer RC,et al．Impact of atrial fibrillation on the in-hospital and long-tern survival of patients with acute myocardial infarction:a community-wide perspective[J].Am Heart J．1990,119(5):996．

[5]Sakata K,Kurihara H,Iwamori K,et a1．Clinical and prognostic significance of atrial fibrillation in acute myocardial infarction [J]．Am J Cardiol, 1997，80(12):1522．

[6]Nagahama Y，Sugiara T,Takehana K，et al. The role of infarction-associated pericarditis on the occurrence of atrial fibrillation[J]．Eur Heart J，1998,19(2):287．

[7]Sugiara T,Iwasaka T,Takahashi N,et a1．Factors associated with atrial fibrillation in Q wave anterior myocardial infarction [J]．Am Heart J,1991，121:1409.

[8]Helmers C,Lundman T，Mogenson L,et a1．Atrial fibrillation in acute myocardial infarction[J]．Acta Med Scand，1973,193：39.

备注/Memo

备注/Memo:
收稿日期：1999-12-02.
更新日期/Last Update: 2001-03-01