H型高血压与初发急性心肌梗死患者近期预后的关系
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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≥10μmol/L) 176例与对照组(Hcy <10μmol/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。
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.
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.
引文
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[3]Scotti A V,Tura B R,Rocha R G,et al.Prognostic value of B-type natriuretic peptide in the mortality of patients with acute coronary syndrome[J].Arq Bras Cardiol,2012,99(1):605-612.
[4]Lentz S R.Mechanisms of thrombosis in hyperhomocysteinemia[J].Curr Opin Hematol,1998,5(5):343-349.
[5]Sacco R L,Adams R,Albers G,et al.Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack:statement for highchair professionals from the American Heart Association/American Stroke Association Council on Stroke:cosponsored by the Council on Cardiovascular Radiology and Intervention:the American Academy of Neurology affirms the value of this guideline[J].Stroke,2006,37(2):577-617.
[6]Sun Y,Chien K L,Hsu H C,et al.Use of serum homocysteine to predict stroke,coronary heart disease and death in ethnic Chinese.12-year prospective cohort study[J].Circ J,2009,73(8):1423-1430.
[7]Homocysteine Studies Collaboration.Homocysteine and risk of ischemic heart disease and stroke:a meta-analysis[J].JA-MA,2002,288(16):2015-2022.
[8]Trkulja V,Car S.On-admission serum uric acid predicts outcomes after acute myocardial infarction:systematic review and meta-analysis of prognostic studies[J].Croat Med J,2012,53(2):162-172.
[9]蔡天志,李凯,辛宏,等.心房颤动合并心功能不全患者血清同型半胱氨酸水平的变化及临床意义[J].山西医药杂志,2014,43(2):133-134.
[10]Blacher J,Demuth K,Guerin A P,et al.Association between plasma homocysteine concentrations and cardiac hypertrophy in end-stage renal disease[J].J Nephrol,1999,12(4):248-255.