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|本期目录/Table of Contents|

影响急性ST段抬高心肌梗死住院病死率性别间差异的因素分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第6期
页码:
913-915
栏目:
临床研究
出版日期:
2010-08-23

文章信息/Info

Title:
Analysis of in-hospital mortality difference between male and female patients with acute ST-segment elevation myocardial infarction
作者:
谭静; 华琦; 李静
首都医科大学宣武医院心脏科，北京 100053
Author(s):
TAN Jing;  HUA Qi;  LI Jing
Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
关键词:
心肌梗死; ST段抬高; 急性; 性别; 住院病死率; 预后
Keywords:
acute ST-segment elevation myocardial infarction;  gender;  in-hospital mortality;  prognosis
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的：调查急性ST段抬高心肌梗死（STEMI）住院病死率性别间有无显著差异及其影响因素。方法: 分析1993年～2006年我院心内科首次发作且发病24 h内入院的1 278例急性STEMI患者的临床资料。结果: 女性患者年龄、并发高血压病、糖尿病、入院空腹血糖、总胆固醇、低密度脂蛋白胆固醇显著高于男性，女性患者无发病诱因、症状不典型者多，发病至就诊时间延长，且住院期间接受血管紧张素转换酶抑制剂(ACEI)、β-受体阻滞剂、他汀类药物以及冠脉介入治疗(PCI)的比例低于男性；Logistic回归分析显示，女性患者住院病死率显著高于男性的影响因素是年龄较大、并发高血压病、入院空腹血糖较高且较少接受ACEI、 β-受体阻滞剂以及PCI治疗。结论: 急性STEMI患者女性住院病死率较男性高，与其并发较多危险因素且未接受更积极的治疗有关。
Abstract:
AIM: To analyze the in-hospital mortality difference between male and female patients with acute ST-segment elevation myocardial infarction (STEMI). METHODS: A retrospective analysis of clinical data was conducted in 1 278 patients with first STEMI who were admitted to our institution within 24 h of symptom onset. RESULTS: Compared with males, females were older and had a higher incidence of hypertension and diabetes mellitus and higher levels of fasting plasma glucose, total cholesterol and low-density lipoprotein cholesterol. Fewer women took angiotensin-converting enzyme (ACE) inhibitors, β-blockers, or statins or had percutaneous coronary intervention. Logistic regression analysis revealed that age, hypertension, fasting plasma glucose and lower use of ACE inhibitors, β-blockers and percutaneous coronary intervention were independently associated with in-hospital mortality in patients with acute STEMI. CONCLUSION: Higher in-hospital mortality after an acute STEMI in women can be explained by older age, more concomitant diseases and less aggressive treatment.

参考文献/References

［1］Rogers WJ, Frederick PD, Stoehr E, et al. Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the national registry of myocardial infarction from 1990 to 2006［J］. Am Heart J, 2008, 156(6):1026-1034.

［2］Reina A, Colmenero M, Aguayo de Hoyos E, et al. Gender differences in management and outcome of patients with acute myocardial infarction［J］. Int J Cardiol, 2007, 116(3):389-395.

［3］Koek HL, de Bruin A, Gast F, et al. Short- and long-term prognosis after acute myocardial infarction in men versus women［J］. Am J Cardiol, 2006, 98(8):993-999.

［4］Jiang SL, Ji XP, Zhao YX, et al. Predictors of in-hospital mortality difference between male and female patients with acute myocardial infarction［J］. Am J Cardiol, 2006, 98(8):1000-1003.

［5］Lavi S, Kapeliovich M, Gruberg L, et al. Hyperglycemia during acute myocardial infarction in patients who are treated by primary percutaneous coronary intervention: impact on long-term prognosis［J］. In J Cardiol, 2008,123 (2):117-122.

［6］Schiele F, Descotes-Genon V, Seronde MF, et al. Predictive value of admission hyperglycaemia on mortality in patients with acute myocardial infarction［J］. Diabet Med, 2006, 23 (12):1370-1376.

［7] Heer T, Gitt AK, Juenger C, et al. Gender differences in acute non-ST-segment elevation myocardial infarction［J］. Am J Cardiol, 2006, 98(2):160-166.

［8］Herlitz J, Dellborg M, Karlsson T, et al. Treatment and outcome in acute myocardial infarction in a community in relation to gender［J］. Int J Cardiol, 2009, 135(3):315-322.

备注/Memo

备注/Memo:
收稿日期：2009-06-09.通讯作者：华琦，主任医师，主要从事高血压病、冠心病的研究Email:huaqi5371@medmail.com.cn 作者简介：谭静，住院医师，博士Email:tanjing0810@163.com
更新日期/Last Update: 2010-08-22