性别因素对心肌梗塞急性期预后影响作用的研究

男女两性在心肌梗塞急性期预后上的差别是许多研究观察到的客观现象 ,但性别因素对此差别是否具有独立的作用尚未明确。本文以北京地区 70万自然人群心血管病监测区 1985年 1月 1日至 1990年12月 31日发生的 76 3例急性心肌梗塞病人为研究样本 ,对性别因素对心肌梗塞急性期预后的影响作用进行分析研究 ,研究结果显示 :女性心梗病人急性期病死率 (35.6 % )明显高于男性 (2 1.8% )。在采用多因素Cox回归分析方法调整了年龄、心功能不全等多个预后影响因素的作用后 ,女性急性期死亡的危险近 5倍于男性(RR =4 .99)。本研究结果有助于临床医生评价不同性别心梗病人的预后 ,同时也为今后从生理、病理角度探索性别因素与心梗急性期预后关系的本质提供了方向和依据。

The Impact of Gender Factor on the Prognosis of Acute Myocardial Infarction(AMI)

To identify and analyze the impact of gender factor on the early prognosis of AMI(28 days after onset).Methods All 763 AMI cases aged 25 to 74,which occurred in 700 000 population of the surveillance study-Sino-MONICA during Jan.1,1985 to Dec.31,1990 in Beijing were entered for this study.The case fatality and contributing factors for early prognosis were analyzed with different statistical methods.Results There was a significant sex related differenc in prognosis of AMI. Women had significant higher case fatality than men did(35.6% vs 21.8%) .The result of Cox regression analysis showed:after the effects of other prognostic factors were adjusted,gender remained to be an independent factor on the prognosis of AMI.The relative risk of death during first 28 days of AMI was 4.99(women vs men).Conclusion gender is an independent risk factor for prognosis of AMI.further study is needed to understand the mechanism for the gender difference in prognosis of AMI.