老年冠心病患者急性心肌梗死的危险因素分析

Analysis of risk factors for acute myocardial infarction in elderly patients with coronary heart disease

中文关键词: 老年  急性心肌梗死  危险因素

英文关键词: elderly  acute myocardial infarction  risk factor

中文摘要:

      目的 分析老年冠心病患者急性心肌梗死的危险因素.方法 回顾性分析2020年3月 2022年3月于上海交通大学医学院苏州九龙医院收治的156例老年冠心病患者的临床资料,根据患者是否发生急性心肌梗死(AMI)将其分为AMI组(55例)和非AMI组(101例).收集并比较AMI组和非AMI组患者临床资料和冠脉病变特点;采用Logistic回归分析影响患者发生AMI的危险因素;采用主成分分析(PCA)-决策树模型分析影响脑卒中患者AMI发生的主要危险因素.结果 AMI组患者存在高血压、糖尿病、高血脂等基础疾病及AMI家族史人数占比较非AMI组更高(P＜0.05).AMI组双支和多支血管病变率高于非AMI组患者(P＜0.05).Logistic回归分析显示,存在高血压、糖尿病、高血脂等基础疾病,双支和多支血管病变率过高是冠心病患者发生AMI的独立危险因素(P＜0.05).PCA-CHAID模型分析显示,第一层为血管病变支数,第二层为高血压和糖尿病,得到血管病变支数为双支或多支是影响冠心病患者AMI发生的最主要因素(P＜0.05),高血压和糖尿病在不同支数冠心病患者中均为影响冠心病患者AMI发生的因素(P＜0.05).结论 存在高血压、糖尿病、高血脂等基础疾病,双支和多支血管病变率过高是冠心病患者发生AMI的独立危险因素,其中高血压、糖尿病和血管病变支数为影响冠心病患者AMI发生的主要因素.

英文摘要:

      Objective To analyze the risk factors for acute myocardial infarction(AMI)in elderly patients with coro-nary heart disease(CHD).Methods The clinical data of 156 elderly CHD patients admitted to Suzhou Kowloon Hospital,Medical College,Shanghai Jiaotong University from March 2020 to March 2022 were retrospectively analyzed.According to presence or absence of AMI,patients were divided into AMI group(55 cases)and non-AMI group(101 cases).The clinical data and characteristics of coronary lesions were collected and compared between the two groups.Logistic regression was used to analyze the risk factors for AMI.Principal component analysis(PC A)-decision tree model was used to analyze the main risk factors for AMI in stroke patients.Results The number of patients with underlying diseases such as hypertension,diabetes,hyperlipidemia and family history of AMI in the AMI group was greater than that in the non-AMI group(P＜0.05).The inci-dence of double and multiple vessel disease in the AMI group was higher than that in the non-AMI group(P＜0.05).Logistic regression analysis showed that the presence of underlying diseases such as hypertension,diabetes and hyperlipidemia,and the high incidence of double and multiple vessel lesions were independent risk factors for AMI in CHD patients(P＜0.05).PCA-CHAID model analysis showed that the first layer was the number of vessel lesions,and the second layer was hypertension and diabetes.It indicated that the double or multiple vessel lesion was the most important factor affecting the occurrence of AMI in CHD patients(P＜0.05),and hypertension and diabetes were the main factors affecting the occurrence of AMI in CHD pa-tients with different numbers of vessel lesion(P＜0.05).Conclusion The underlying diseases such as hypertension,diabe-tes,hyperlipidemia,and high incidence of double and multiple vessel lesions are independent risk factors for AMI in CHD patients.Hypertension,diabetes and the number of vascular lesions are the main factors affecting the occurrence of AMI in CHD patients.