目的：探讨急性心肌梗死（AMI）并发初诊心力衰竭住院患者的生存状况。方法将本院收治的160例AMI患者按住院期间是否并发心力衰竭分为心力衰竭组和非心力衰竭组。采用自制表格统计患者一般资料和相关指标。结果160例AMI患者中58例（36.25%）确诊为首发心力衰竭。两组患者在年龄、心率、发病至就诊时间、住院时间、左心室射血分数（LVEF）、合并慢性阻塞性肺疾病比例、肌酸激酶同工酶（CK-MB）、血肌酐（SCr）和血清尿素氮（BUN）方面比较差异均具有显著性（P＜0.05或P＜0.01）。心力衰竭组患者总死亡率、心房颤动、心源性休克和室性心律失常发病率均显著高于非心力衰竭组（P＜0.01）。Logistic回归分析显示，影响AMI患者住院死亡率的因素由高至低依次为Killip分级、并发心源性休克、并发心力衰竭、并发慢性阻塞性肺疾病、LVEF、年龄和CK-MB。结论 AMI首发心力衰竭患者死亡率较高，预后较差，应及时检测相关指标，积极预防AMI患者发生心力衰竭，有助于改善患者预后。%ObjectiveTo study the condition of the patients with acute myocardial infarction (AMI) and heart failure.MethodSelected 160 cases who diagnosed AMI from our hospital, and separated them into heart failure group and non-heart failure group. Used self-made form to analyze general information and related data. Result58 cases (36.25%) of 160 patients with AMI were diagnosed as initial heart failure. The age, heart rate, admission time, duration of hospital stays, LVEF, chronic obstructive pulmonary disease, arrhythmia, CK-MB, SCr and BUN between the two group had signiifcant differences (P<0.05 orP<0.01). The mortality rate, atrial ifbrillation, cardiogenic shock, ventricular arrhythmias occurrence rate of heart failure group were higher than non-heart failure group (P<0.01). The highest to lowest factors which inlfuence the mortality rate of AMI patients were the level of Killip staging, cardiogenic shock, heart failure, chronic obstructive pulmonary disease, LVEF, age and CK-MB.ConclusionThe heart failure with AMI shows higher mortality and bad prognosis. It is necessary to exam related test indexes in time and prevent the occurrence of heart failure with AMI, which can improve the prognosis of patients.
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