1. 山东中医药大学附属医院
2. 山东中医药大学
纸质出版:2015
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[1]戴国华,赵晨,龙凤玺,娄昊,王芳.238例心肌梗死患者终点事件发生情况队列研究[J].中医杂志,2015,56(01):31-35.
DAI Guohua, ZHAO Chen, LONG Fengxi, et al. Cohort Study on the Endpoint Events in 238 Myocardial Infarction Patients[J]. Journal of Traditional Chinese Medicine2015, 56(1): 31-35.
[1]戴国华,赵晨,龙凤玺,娄昊,王芳.238例心肌梗死患者终点事件发生情况队列研究[J].中医杂志,2015,56(01):31-35. DOI: 10.13288/j.11-2166/r.2015.01.009.
DAI Guohua, ZHAO Chen, LONG Fengxi, et al. Cohort Study on the Endpoint Events in 238 Myocardial Infarction Patients[J]. Journal of Traditional Chinese Medicine2015, 56(1): 31-35. DOI: 10.13288/j.11-2166/r.2015.01.009.
目的采用队列研究方法探讨心肌梗死患者终点事件发生的相关因素。方法纳入山东中医药大学附属医院2008年1月至2012年12月期间首次诊断为急性心肌梗死的住院病例
制定中医医院心肌梗死患者队列研究调查表
分别记录住院期间和随访期间患者一般资料、中医药使用情况、终点事件发生情况
包括事件种类、发生时间、次数及依据
并采用多元Logistic回归分析法分析中医药治疗、年龄、性别、合并症、药物治疗情况等指标与心肌梗死患者终点事件发生的相关性。结果共纳入238例心肌梗死患者
完成随访152例。住院期间心肌梗死患者终点事件发生率最高的前3位依次是急性心力衰竭(18.49%)、心源性死亡(16.81%)、心源性休克(14.45%);随访期间终点事件发生率最高的前3位依次是心血管再入院(30.19%)、心源性死亡(25.16%)、急性心力衰竭(13.84%)。住院期间中医药治疗(OR=7.753)、年龄(OR=1.230)是心源性死亡的相关因素
年龄(OR=1.055)是急性心力衰竭的相关因素
年龄(OR=1.072)是心源性休克的相关因素;随访期间抗栓治疗药物(OR=2.831)、降脂药物(OR=2.696)、血糖异常(OR=2.734)、中医药治疗(OR=1.528)、年龄(OR=1.053)是心源性死亡的相关因素
血糖异常(OR=2.793)、中医药治疗(OR=1.587)、年龄(OR=1.054)是发作性心力衰竭相关因素
年龄(OR=1.074)是严重心律失常相关因素。结论中医药干预、年龄、合并症等是心肌梗死患者终点事件发生的相关因素
其中中医药干预可有效预防心肌梗死患者心源性死亡和出院随访期间急性心力衰竭的发生。
Objective To investigate the related factors of endpoint events in myocardial infarction( MI)patient. Methods Hospitalized cases with first diagnosis of acute myocardial infarction from January 2008 to December 2012 in Affiliated Hospital of Shandong University of Traditional Chinese Medicine were collected. In the period of hospitalization and follow-ups
cohort study questionnaire for the Chinese medicine hospital was applied to record general information
usage of traditional Chinese medicine( TCM)
types and time of the endpoint events
number of occurrence and evidence. Logistic regression analysis was used to analyze the correlation of TCM intervention intensity
age
gender
complications
drug usage and other indicators with the occurrence of endpoint events.Results Totally 238 MI patients were included and 152 patients had complete follow-ups. In hospitalization
the top three endpoint events in MI patients were acute heart failure( AHF
18. 49%)
cardiac death( CD
16. 81%) and cardiogenic shock( CGS
14. 45%). In the follow-ups
the top three endpoint events were cardiac readmission( 30. 19%)
CD( 25. 16%) and AHF( 13. 84%). In hospitalization
TCM intervention intensity( OR = 7. 753)and age( OR = 1. 230) were related factors of CD
while age( OR = 1. 055) was a related factor of AHF and age( OR = 1. 072) was that of CGS. In the follow-ups
antithrombotic medication( OR = 2. 831)
cholesterol-lowering medication( OR = 2. 696)
pathoglycemia( OR = 2. 734)
TCM intervention intensity( OR = 1. 528) and age( OR = 1. 053) were related factors of CD
while pathoglycemia( OR = 2. 793)
TCM intervention intensity( OR =1. 587) and age( OR = 1. 054) were that of AHF and age( OR = 1. 074) was that of severe arrhythmia. Conclusion TCM intervention
age
complications were related factors to the endpoint events in MI patients and TCM intervention could effectively prevent CD and AHF in follow-ups.
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