487例急性ST段抬高型心肌梗死死亡原因及处理对策分析

目的:探讨急性ST段抬高心肌梗死主要的死亡原因及降低死亡率所应采取的对策。方法:对我院2005年1月～2009年1月收住的487例急性ST段抬高型心肌梗死,进行病例资料分析,及为期1年的随访,调查急性期及1年随访期间的死亡病例的死因及导致死亡的临床因素,包括年龄、梗死部位、所采取的再灌注治疗、并发症、左室功能、再缺血的评估及危险分层,并与同期存活的患者进行对照。结果:487例急性心肌梗死急性期死亡53例;急性期死亡的主要原因为:心脏的泵衰竭,心源性休克及机械并发症;1年随访新增死亡病例26例,主要死亡原因为泵衰竭;死亡病例与以下临床因素相关:广泛前壁心肌梗死,未进行再灌注治疗,梗塞后左室功能不全,反复发作的心肌缺血,心源性休克及机械并发症。结论:急注治疗通过危险分层、适时的介入干预可降低死亡率。

Analysis of the cause of death and treatment in 487 patients with ST-segment elevation acute myocardial infarction (STEMI)

Objective:To evaluate the cause of death in STEMI patiets and to reduce the mortality rate.Methods:From January 2005 to January 2009,487 STEMI patients were involved in this study,The clinical factors of the death of STEMI patients were analyzed,Including age,areas of intervention,re-perfusion therapy,complation,left ventricnle function,the re-ischemic and risk factors.And compared with the survival patients in the same time.Results:There were 53 patients dead in early period and these patients were associated with some risk factors such as: extensive anteriorm cardial infarction,without re-perfusion therapy,post-infarectional heart failure,recurret myocardial ischemic,cardiogenic shock and mechanical complication.There were 26 new dead patinets in one-year fellow-up.The major reason of the death was heare failure of pose-myocardical infarction.Conclusion:Early re-ischemic and properly PCI threaphy may decrease the mortality of STEMI patients.