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关键词：急性心肌梗死；近期死亡率；病理解剖
【摘要 】 本文分析我院10年间住院急性心肌梗死(AMI)患者的死亡率为13%，约80%发生在发病7 d内，头3 d死亡率为46%。再梗死患者死亡多在7 d内，梗死面积越大，并发症及心律失常越多，生存期越短。并发急性胃粘膜病变可提示预后不良。在AMI的稳定期和恢复期尚不能排除猝死的可能性。尸检提示AMI死亡的患者多为3支以上的血管病变。其狭窄为Ⅲ～Ⅳ级，心脏破裂发生率较高(18%)， 临床诊断率4.6%， 多发生在头7 d内。
Analysis of early mortality in patients with acute myocardial infarction for ten years
Wang Dongmei,Tong Ming, Tang Li
et al Shenyang Military General Hospital, Shenyang,Liaoning 110015
【Abstract】 Objective To analyse early mortality and relative factors in patients with AMI and to analyse vessels diseases by necropsy findings.Methods A total of 551 patients with AMI,72 died in hospital(≤30 days), 55 were men and 17 were women (mean age 65.44±9.23 years). Group I:patients died≤7 days,GroupⅡ: patients died>7 days.Results The hospital mortality was 13% for 551 patients,80% died within 7 days,46% died within 3 days. Compared with groupⅡ,group Ⅰ with hypertension and heperlipidemic and diabets mellitus were greater than groupⅡ(P<0.05). Most of groupⅠwith first AMI,but most of groupⅡ with reinfarction(P<0.05).Myocardial infarctions in groupⅠwere more than two walls,those in groupⅡ were one wall (P<0.05). The sudden deaths in groupⅡ were more than that in groupⅠ(P<0.01).Necropsy findings group Ⅰ with three vessels disease were greater than groupⅡ.Conclusion Most of deaths with AMI occurred with in 7 days. The greater the infarctions were,the more the complications occurred,the lees time of sarvived was.The sudden deaths in AMI occurred possilby during the stationary phase and the recovery time.Necropsy prompts most deaths within 7 days were observed with three vessels disease. Heart ruptures were 18%, clinical diagnoses were 46%.
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