中文摘要
齐齐哈尔市某三甲医院急性心肌梗死住院患者病例分析
目的：
收集齐齐哈尔市某三甲医院ICU科确诊200例急性心肌梗死住院患者的临床资料，分析本地急性心肌梗死患者一般情况、治疗方式及效果、预后及相关危险因素等，为控制AMI发生发展，指导本地区AMI三级预防和规范疾病监测，以及卫生行政部门的决策制定提供基础数据和理论参考。
方法：
本研究采取回顾分析法，入选2014年1月至2016年6月于齐齐哈尔市某三甲医院ICU科住院的200例急性心肌梗死患者，所有入选病例均采集年龄、性别、既往病史（即高血压、糖尿病、脑梗塞病史），并测定血糖、血脂、心肌酶谱、肌钙蛋白T、白细胞、纤维蛋白原水平，描记心电图。于入院即刻、入院1天、7天时测定血清NT-pro BNP水平，心脏彩超监测入院即刻、入院1天、7天时左室射血分数（LVEF）、左心室舒张末期内径（LVED），对所有患者进行为期1年的随访，记录不良心血管事件(MACE)。
结果：
1.本研究对象共200人，其中年龄64.13±9.90，血糖7.72±3.13，白细胞8.79±
2.12，纤维蛋白原
3.40±0.79，甘油三酯3.67±0.86，胆固醇5.17±0.94，CK(U/L)490.32±81.69，CK-MB(U/L)129.42±30.81，TnT(ng/L)1.23±0.23。男性138人（69.00%），女性62人（31.00%）；有高血压病史的136人（42.6%），无高血压病史的64人（32.00%）；有糖尿病病史的95人（47.50%），无糖尿病病史的为105人（52.50%）；有脑梗塞病人的有35人（17.50%），无脑梗塞病史的有165人（82.50%）；行PCI术组的有120人（60.00%），未行PCI术的有80人（40.00%）。扁桃体发炎偏方
2.患者住院期间主要临床指标的分析
将两组数据进行比较，在NT-pro BNP（F=25.342，P<0.001）、LVEF（F=8.465，P=0.005）、LVED（F=8.156，P=0.005）水平上，两组患者之间具有统计学差异。
并且在入院即刻NT-pro BNP、入院1天NT-pro BNP、入院7天NT-pro BNP、
入院1天LVEF、入院7天LVEF和入院7天LVED水平上，两组之间具有统计学差异（P<0.05）。在入院即刻LVEF、入院即刻LVED、入院1天LVED水平上，两组间均无统计学差异（P>0.05）。
对两组患者的心电图指标进行比较，两组在心电图抬高导联数与心电图抬高导联和方面无统计学差异（P>0.05）。
对两组患者不良心血管事件发生情况进行比较，两组之间具有统计学差异
（ 2=3.653，P=0.032）。
3.以不良心血管事件为因变量，年龄、性别、高血压、糖尿病、脑梗塞、空腹血糖、白细胞、纤维蛋白原、甘油三酯、胆固醇、肌酸激酶、心电图抬高导联数、心电图抬高导联和、入院7天NT-proBNP、入院7天LVEF、入院7天LVED为自变量，对所有数据进行单因素回归分析提示糖尿病病史、心电图抬高导联数、心电图抬高导联和、年龄、空腹血糖、肌酸激酶、入院7天NT-proBNP、入院7天LVEF和入院7天LVED与不良心血管事件发生有相关性，且具有统计学意义（P<0.05）。
将单因素分析中有意义的变量进一步做逐步多因素Logistic回归，结果显示糖尿病（OR=359.738）、心电图抬高导联和（OR=3.866）、入院7天NT-proBNP （OR=1.005）和入院7天LVED（OR=2.172）是不良心血管事件发生的危险因素（P<0.05）。
结论：
1.本研究中急性心肌梗死患者中，男性多于女性，发病年龄偏低，多合并高血压、高血脂、糖尿病、
脑梗塞病史，介入治疗比例高。
2.急性心肌梗死PCI治疗可降低NT-pro BNP、LVED水平，提高LVEF水平，降低不良心血管事件的发生。
抓肉鸡3.糖尿病、心电图抬高导联和、入院7天NT-pro BNP和入院7天LVED是急性心肌梗死不良预后的独立危险因素，对1年内不良心血管事件的发生具有很高的预测价值。
关键词：
给自己写个人主要事迹
急性心肌梗死，冠状动脉介入，N端脑利钠肽前体，心血管事件
Abstract
Analysis of hospitalized patients with acute myocardial infarction in
a3A degree hospital in Qiqihar City养肝的食物
Objectives:
The collection of ICU Department of a hospital diagnod200cas of hospitalized patients with acut
e myocardial infarction(AMI)clinical data in Qigihar city,analysis of local acute myocardial infarction patients with the general situation, treatment and effects,prognosis and risk factors,to control the occurrence and development of AMI,guiding the AMI three specification for prevention and dia monitoring,provide basic data and theoretical the reference and the administrative department of health decision-making.
你是我的唯一用英语怎么说善良的心就是太阳Methods:
This rearch adopts the retrospective analysis of200cas of patients with acute myocardial infarction from January2014to June2016in the Department of ICU in a 3A degree hospital in Qigihar,all the cas were collected,age and gender , history of hypertension,diabetes,cerebral infarction),and determination of blood sugar,blood lipid,myocardial enzymes,Troponin T,white blood cells,the level of fibrinogen,electrocardiogram.On admission,on the1day and7day rum NT-pro BNP levels,cardiac ultrasound monitoring of admission and on the1day and7days when the left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVED),for a period of1years of follow-up for all patients,major advercardiovascular events(MACE).
Results:
夜深人静的近义词1.,200subjects were included in the study,including age64.13+9.90,blood sugar7.72+3.13,white blood cell8.79+
2.12,fibrinogen
3.403.40,0.79, triglyceride3.67,3.67,cholesterol,CK,CK-MB,TnT.138men(69%),62female (31%);136people have a history of hypertension(42.6%),64people without hypertension history(32%);95people have a history of diabetes(47.50%),without a
history of diabetes was105(52.50%);there are patients with cerebral infarction(35 people17.50%),no cerebral infarction history of165people(82.50%);PCI group of 120people(60%),without PCI was the80people(40%).
2.Analysis of the main clinical indexes of the patients during hospitalization The two ts of data were compared.In NT-pro BNP(F=25.342,P<0.001),LVEF (F=8.465,P=0.005),LVED(F=8.156,P=0.005)level,there was statistical difference between the two groups.And there was a statistically significant difference between the two groups at NT-pro BNP,1days,NT-pro BNP,7days,NT-pro days,1days,1 days,7days,and7days.There was no statistical difference between the two groups (P>0.05)at the level of LVEF at immediate admission,immediate
admission to hospital,and1days of admission to the hospital at1days.The electrocardiogram indexes of the two groups were compared,and there was no statistical difference between the two groups in the ECG elevation lead number and the ECG elevation lead sum(P>0.05).Comparison of two groups of patients with adver cardiovascular events,with statistically significant difference between the two groups( 2=
3.653, P=0.032).
3.With the dependent variable of adver cardiovascular events,age,gender, hypertension,diabetes,cerebral infarction,fasting blood gluco,white blood cells, fibrinogen,triglyceride,cholesterol,creatine kina,ECG elevation lead number, ECG elevation lead sum,on the7day NT-pro BNP,the7day of admission,admission LVEF7days LVED as independent variables,all the data were analyzed by single factor regression analysis showed that history of diabetes,the number of leads ECG, ECG elevation elevation,lead and age,fasting blood gluco,creatine kina,creatine kina isoenzyme,NT-pro BNP on the7day of admission,7days LVEF and7days after admission of LVED and major advercardiovascular events are related,and with statistical significance(P<0.05).Single factor analysis showed significant variables further stepwi multivariate Logistic regression,results showed that diabetes mellitus(OR=359.738),ECG el
evation lead sum(OR=3.866),on the7day of NT-pro BNP(OR=1.005)and the7day of admission LVED(OR=2.172)is a risk factor for adver cardiovascular events occurred(P<0.05).
Conclusion:
1.In this study,the number of male patients is more than that of women,and the age of ont is low.Most of them are associated with hypertension,hyperlipidemia,
diabetes and history of brain death.
2.PCI treatment in acute myocardial infarction can reduce the level of NT-pro BNP and LVED,improve the level of LVEF and reduce the incidence of adver cardiovascular events.
3.diabetes,ECG elevation lead sum,7days of admission NT-pro BNP and7 days of admission LVED is an independent risk factor for the prognosis of acute myocardial infarction,and has a high predictive value for the occurrence of adver cardiovascular events within1years.登山的目的
Key words:
acute myocardial infarction，percutaneous coronary intervention，NT-pro BNP，major adver cardiovascular events
