[1]陈冬生,杨跃进.不同Killip分级急性心肌梗死患者年龄分布特征及其与预后的关系[J].新乡医学院学报,2018,35(4):285-288.[doi:10.7683/xxyxyxb.2018.04.007]
 CHEN Dong-sheng,YANG Yue-jin.Characteristics of age distribution in acute myocardial infarction patients with different Killip grades and its relationship with prognosis[J].Journal of Xinxiang Medical University,2018,35(4):285-288.[doi:10.7683/xxyxyxb.2018.04.007]
点击复制

不同Killip分级急性心肌梗死患者年龄分布特征及其与预后的关系
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
35
期数:
2018年4
页码:
285-288
栏目:
临床研究
出版日期:
2018-04-05

文章信息/Info

Title:
Characteristics of age distribution in acute myocardial infarction patients with different Killip grades and its relationship with prognosis
作者:
陈冬生1杨跃进2
(1.平顶山市第二人民医院心内科,河南 平顶山 467000;2.中国医学科学院阜外心血管病医院,北京 100037)
Author(s):
CHEN Dong-sheng1YANG Yue-jin2
(1.Department of Cardiology,the Second People′s Hospital of Pingdingshan,Pingdingshan 467000,Henan Province,China;2.Fuwai Cardiovascular Disease Hospital,Chinese Academy of Medical Science,Beijing 100037,China)
关键词:
急性心肌梗死Killip分级年龄预后
Keywords:
acute myocardial infarctionKillip gradeageprognosis
分类号:
R542.2+2
DOI:
10.7683/xxyxyxb.2018.04.007
文献标志码:
A
摘要:
目的 探讨不同Killip分级中国急性心肌梗死(AMI)患者的年龄分布特征及其与预后的关系。方法 选择中国急性心肌梗死注册研究入选的诊断为AMI患者25 243例。根据患者年龄分为≤54岁、55~64岁、65~74岁、≥75岁4个年龄段,并根据入院时临床表现进行Killip分级。分析不同Killip分级患者在各个年龄段的比例及不同分级患者的预后。结果 总体上Killip各级患者在不同年龄段所占的比例随着年龄的增长呈增加趋势,其中Killip Ⅰ~Ⅲ级AMI患者在不同年龄段所占的比例两两比较差异均有统计学意义(P<0.01);Killip Ⅳ级患者在55~64岁、65~74岁、≥75岁患者中所占的比例高于≤54岁患者(P<0.01);Killip Ⅳ级患者在 65~74岁、≥75岁患者中所占的比例高于55~64岁患者(P<0.01);65~74岁和≥75岁患者中Killip Ⅳ级患者所占的比例比较差异无统计学意义(P>0.05)。Killip分级越高,患者的病死率及出血、再次心肌梗死和新发卒中发生率越高,不同Killip分级患者病死率及出血、再次心肌梗死和新发卒中发生率比较差异均有统计学意义(P<0.01)。随着AMI患者年龄的增大,Killip分级的增高,病死率大致呈逐渐升高趋势(P<0.001)。结论 在中国的AMI患者中,Killip Ⅲ+Ⅳ级多为老年人,≥75岁的老年患者所占的比例明显高于<75岁各个年龄段的患者。Killip分级越高,年龄越大,其病死率越高。
Abstract:
Objective To investigate the characteristics of age distribution in acute myocardial infarction(AMI) patients with different Killip grade,and analyze its relationship with the prognosis.Methods A total of 25 243 patients with AMI which from the Chinese registry study of acute myocardial infarction were enrolled in this study.All patients were divided into four age groups (≤54 years old,55-64 years old,65-74 years old and ≥75 years old).Killip grade was carried out according to the clinical manifestation of admission of patients.The proportion of different Killip grade patients in different age group and the prognosis of different Killip grade of patients were analyzed.Results Totally,the proportion of different Killip grade patients in different age group increased with the increase of age;there was statistic difference in the proportion of KillipⅠ-Ⅲ patients between ≤54 years old,55 - 64 years old,65-74 years old,≥75 years old patients(P<0.01);the proportion of KillipⅣ patients in 55-64 years old,65-74 years old and ≥75 years old patients was significantly higher than that in the ≤54 years old patients(P<0.01);the proportion of KillipⅣ patients in 65-74 years old,≥75 years old patients was significantly higher than that in the 55-64 years old patients(P<0.01);there was no statistic difference in the proportion of KillipⅣ patients in 65-74 years old,≥75 years old patients(P>0.05).The higher the Killip grade,the higher the mortality and the incidence of bleeding,the recurrence of myocardial infarction and new onset of stroke;there was statistic difference in the mortality rate and the incidence of bleeding,the recurrence of myocardial infarction and new onset of stroke among different Killip grade (P<0.01).The mortality rate of AMI patients increased with the increase of age and Killip grase,the difference was statistically significant (P<0.001).Conclusion Among patients with AMI in China,most patient of Killip grade III+IV are the elderly,and proportion of ≥75 years old are more than those <75 years old.In AMI patients,the higher the Killip grade and the age is,the higher the mortality rate is.

参考文献/References:

[1] THYGESEN K,ALPERT J S,JAFFE A S,et al.Third universal definition of myocardial infarction[J].Global Heart,2012,126(16):2020.
[2] KIM G R,HUDSON K W,MILLER C A.The evolution of EHR-S functionality for care and coordination[M].New York:Springer International Publishing,2016:73-99.
[3] WEINTRAUB W S,KARISBERG R P,TCHENG J E.ACCF/AHA 2011 key date elements and definitions of a base cardiovascular vocabulary for electronic health records:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Data Standards[J].J Am Coll Cardiol,2011,58(2):202-222.
[4] 伏蕊,杨跃进,窦克飞,等.中国不同年龄段急性心肌梗死患者临床特征和诱发因素的差异性分析[J].中华心血管病杂志,2016,44:1-6.
[5] PETERSON E D,ROE M T,MULGUND J,et al.Association between hospital process performance and outcomes among patients with acute coronary syndromes[J].JAMA,2006,295(16):1912-1920.
[6] GALE C P,CATTLE B A,WOOLSTON A,et al.Resolving inequalities in care? Reduced mortality in the elderly after acute coronary syndromes.The Myocardial Ischaemia National Audit Project 2003-2010[J].Eur Heart J,2012,33(5):630-639.
[7] DODD K S,SACZYNSKI J S,ZHAO Y,et al.Exclusion of older adults and women from recent trials of acute coronary syndromes[J].J Am Geriatr Soc,2011,59(3):506-511.
[8] MOZAFFARIAN D,BENJAMIN E J,GO A S,et al.Heart disease and stroke statistics—2015 update:a report from the American Heart Association[J].Circulation,2016,131(4):e29-e322.
[9] EL-MENYAR A,ZUBAID M,ALMAHMEED W,et al.Killip classification in patients with acute coronary syndrome:insight from a multicenter registry[J].Am J Emerg Med,2012,30(1):97-103.
[10] JEGER R V,URBAN P,HARKNESS S M,et al.Early revascularization is beneficial across all ages and a wide spectrum of cardiogenic shock severity:a pooled analysis of trials[J].Acute Card Care,2011,13(1):14-20.
[11] LIM H S,FAROUQUE O,ANDRIANOPOULOS N,et al.Survival of elderly patients undergoing percutaneous coronary intervention for acute myocardial infarction complicated by cardiogenic shock[J].Int J Cardiol,2015,195(2):259.
[12] ANAND S S,ISLAM S,ROSENGREN A,et al.Risk factors for myocardial infarction in women and men:insights from the INTERHEART study[J].Eur Heart J,2008,29(7):932-940.
[13] 郑昕,李建军,杨跃进,等.近15年间急性心肌梗死患者的性别年龄演变趋势[J].中国循环杂志,2010,25(6):441-444.
[14] GRUNDTVIG M,HAGE T P,GERMAN M,et al.Sex-based differences in premature first myocardial infarction caused by smoking:twice as many years lost by women as by men[J].Eur J Cardiovasc Prev Rehabil,2009,16(2):174-179.
[15] 吴伟力,傅向华,马宁,等.缺血预适应及侧支循环对缺血再灌注心肌的保护作用[J].中华心血管病杂志,2004,32(8):717-722.
[16] 冯伟萍,唐其柱.老年及成年AMI患者心肌缺血预适应保护作用的对比分析[J].医学研究杂志,2010,39(10):91-93.

相似文献/References:

[1]张子虹,李俊臣.硝普钠治疗急性心肌梗死泵衰竭30例[J].新乡医学院学报,2001,18(05):361.
[2]刘金锌 关慧是.急性心肌梗死后左室重构与b-受体阻滞剂干预研究进展[J].新乡医学院学报,2002,19(02):140.
[3]孟令波 王玉柱.急性心肌梗死患者静脉溶栓开始时间对溶栓疗效的影响[J].新乡医学院学报,2002,19(02):123.
[4]熊红武 . 孟凡菊,熊芬霞.急性心肌梗死患者心电图ST段“墓碑形”改变的临床意义[J].新乡医学院学报,2002,19(01):049.
[5]张素荣,袁 宇,赵国安,等.阿替洛尔对急性心肌梗死Q—T及Q—Tc离散度的影响[J].新乡医学院学报,2003,20(02):117.
[6]赵俊环.急性心肌梗死患者院前安全转运及救护[J].新乡医学院学报,2003,20(06):453.
[7]赵俊环.急性心肌梗死患者院前安全转运及救护[J].新乡医学院学报,2003,20(06):453.
[8]曹丽,周发展,张君.危重急性心肌梗死合并急性胰腺炎1例 [J].新乡医学院学报,2006,23(02):000.
[9]王景斌,仝峰,苏毅.急性心肌梗死溶栓后24h内T波倒置的临床意义 [J].新乡医学院学报,2007,24(01):072.
[10]信金柱,曹泽林,王俊霞.短时低血压致急性心肌梗死1例[J].新乡医学院学报,2009,26(03):000.

更新日期/Last Update: 2018-04-05