| Left heart failure is an important clinical manifestation of acute myocardial infarction ( AMI ), and it is an important factor that affects AMI patient prognosis. Performing reperfusion treatment in early stage can reduce the area of myocardial infarction of these patients , is the key of preserving left heart function. However, in clinical practice ,even if reperfusion treatment were performed in time window, even the infarction related artery was recanalizated , there still had many cases occurring heart failure. The interpretation may be there are other risk factors that affectted the heart function of those patients. Objectives The aim of this study was to investigate factors that independently contributed to the in hospital cardiac function in patients who had suffered acute myocardial infarction and undergone thrombolysis therapy. Methods One hundred-thirty-six hospitalized patients of the First Clinical Medicine College of Shanxi Medical University from January ,1997 to July ,2003 who had undergone the first AMI and thrombolysis therapy were selected as study population. In these patients, one hundred-nineteen was male and seventeen was female,and the average age was 58.1 ±10.7, fifty-nine patients had inferior wall myocardial infarction, seventy-seven patients had anterior wall myocardial infarction , fifteen patients complicated right wall myocardial infarction, thirty-one patients complicated posterior wall myocardial infarction. The average in hospital time was 19.7 ±13.9 day. The drug of thrombolysis therapy for One hundred-twenty-one patients was urokinase, for fifteen patients was streptokinase. Blood vessel were unobstructed in eighty-six cases, not unobstructed in fifty cases. According to in hospital heart function, the patients were divided into two groups, in which, the heart function of ninety-seven (70.6%) patients were normal(Killip I), the heart function of forty (29.4%) patients were unnormal (Killip II,III,IV). The related clinical information that were collected includes: age , sex , the time from onset of illness to hospitalization , the history of angina pectoris former and 48 hours before onset of illness, smoking history, the history of hypertension and diabetes mellitus, blood pressure of admission , the drug of thrombolysis therapy , the time from onset of illness to performing thrombolysis therapy, the recanalization of infarction related artery ,the serum MB isoenzyme of creatine kinase (CK-MB) peak value , plasm blood white cell count of admission, plasm lipid concentration,the electrocardiogram before and after thrombolysis therapy . The measured electrocardiogram markers includes: the summation of ST segment deviation before and two hours after performing thrombolysis therapy,the recovery percentage of ST segment deviation two hours after thrombolysis therapy and the leads number of ST segment deviation before thrombolysis therapy. After group comparison, logistic multivaritate stepwise regression analysis was performed .Results In the group comparison, the variance of statistics with notable meaning were: age ( P < 0.001 ) , the history of angina pectoris ( P = 0.029 ) , the history of diabetes mellitus ( P = 0.040 ) , serum CK-MB peak value ( P < 0.001 )and the summation of ST segment deviation before thrombolysis therapy ( P = 0.023 ), possible meaningful variance were AMI location ( P = 0.098 ) and diastolic pressure of admission ( P = 0.090 ). In multivaritate logistic analysis and forward stepwise selection (The entry standard is P<0.05,and the removal standard is P>.10),the following factors appeared to be the independent risk factor of the heart failure after AMI: serum CK-MB peak value, age, the summation of ST segment deviation before thrombolysis therapy and the heart rate of admission. The odds ratio value of the variance mentioned above were 5.241(P<0.001), 2.973(P<0.001), 2.992(P=0.006) and 5.244(P=0.045) respectively. The test value of chi-squared test for the regression equation is 46.227 (P<0.001). The regression equation holds on an...
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