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目的:评估入院肾功能对急性ST段抬高心肌梗死(STEMI)患者院内预后的影响。方法:入选718例STEMI患者,分为肾功能正常或轻度肾功能不全组(A组)和中重度肾功能不全组(B组),比较两组的临床特点和院内预后。结果:133例STEMI患者存在中重度肾功能不全。与A组相比,B组患者年龄大、女性较多、合并高血压、糖尿病、冠心病、心力衰竭病史多;B组的患者住院期间新出现的心力衰竭和恶性心律失常发生率明显增加,院内死亡率亦显著增高。多因素Logistic回归分析显示,中重度肾功能不全是SrTEMI患者院内死亡的独立危险因素。结论:肾功能不全患者住院期间发生心力衰竭、恶性心律失常增加,院内死亡率增高,中重度肾功能不全是院内死亡的独立危险因素。
Objective: To evaluate the effect of admission renal function on in-hospital prognosis in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 718 patients with STEMI were enrolled and divided into three groups: group A with normal renal function or with mild renal dysfunction (group A) and group with moderate or severe renal insufficiency (group B). The clinical features and in-hospital prognosis were compared between the two groups. Results: 133 cases of STEMI patients with moderate to severe renal insufficiency. Compared with group A, patients in group B were older and more females with a history of hypertension, diabetes, coronary heart disease and heart failure. The incidence of heart failure and malignant arrhythmia in group B was significantly increased during hospitalization, In-hospital mortality also increased significantly. Multivariate Logistic regression analysis showed that moderate-severe renal insufficiency was an independent risk factor for in-hospital mortality in SrTEMI patients. CONCLUSION: Heart failure occurs during hospitalization in patients with renal insufficiency. Malignant arrhythmia increases and in-hospital mortality increases. Moderate-severe renal insufficiency is an independent risk factor for nosocomial death.