目的 研究初发急性ST段抬高型心肌梗死（STEMI）患者的受教育程度与预后的相关性。方法 连续入组2018年1月至2019年12月于南京医科大学附属淮安第一医院心内科住院，首次罹患STEMI的患者191例，根据患者受教育程度分组并随访1年。采用Cox回归模型评估患者出院1年内发生主要不良心血管事件（MACE）的风险及其影响因素。结果 与受教育程度低组相比，受教育程度高组的患者年龄更加年轻，且男性居多，多伴有吸烟史及肥胖，低密度脂蛋白胆固醇（LDL-C）水平和左室射血分数（LVEF）更高，梗死相关血管开通更早，出院1年内MACE的发生率较低，差异具有统计学意义（P＜0.05）。多因素Cox回归分析显示，受教育程度高是出院1年内发生MACE的独立预测因素和保护因素（HR=5.584，95%CI：1.091~28.563，P=0.039）。结论 初发STEMI患者的受教育程度与预后呈独立的负相关关系，受教育程度高的患者出院后1年内发生MACE的风险较低。

Objective To study the correlation between education level and prognosis in patients with primary ST-segment elevation myocardial infarction (STEMI). Methods STEMI patients (n=191) were chosen from Department of Cardiology in The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from Jan. 2018 to Dec. 2019, and divided into groups according to their education levels and followed up for 1 y. The risk factors and influence factors of major adverse cardiovascular events (MACE) occurred within 1 y after discharged were reviewed by using Cox regression model. Results Compared with low education level group, the patients were younger and most of them were male with smoking history and obesity, the levels of low-density lipoproteincholesterol (LDL-C) and left ventricular ejection fraction (LVEF) were higher, infarction-related arteries were opened earlier, and incidence rate of MACE within 1 y was lower in high education level group (all P<0.05). The results of Cox regression analysis showed that high education level was an independent predictive and protective factor of MACE occurred within 1 y after discharged (HR=5.584, 95%CI: 1.091~28.563, P=0.039). Conclusion The education level and prognosis show an independent negative correlation in patients with primary STEMI, and risk of MACE is lower in patients with higher education level within 1 y after discharged.

中华国际医学交流基金会整合思维研究基金(z-2016-23-2101-46);淮安市自然科学研究计划(HAB202025)