行经皮冠状动脉介入治疗的冠心病患者预后影响因素分析
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摘要
目的分析1500例行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的冠心病(coronary heart dis ease,CHD)患者预后的影响因素。方法选取本院2014年12月至2017年7月收治的1500例行PCI的冠心病患者为研究对象,按是否发生主要不良心脏事件(major adverse cardiac events,MACE)将其分为预后良好组和预后不良组,采用多因素Logistic回归分析探讨影响患者预后的因素。结果 1500例患者均完成1年随访,MACE发生率为16.00%。多因素Logistic回归分析显示:有冠心病家族史、合并糖尿病、左室射血分数、血细胞比容、平均红细胞体积、红细胞分布宽度、N末端B型利钠肽原、高敏C反应蛋白均是影响PCI患者预后的独立危险因素(P_均<0.05)。结论行PCI的患者术后MACE发生风险高,应高度重视合并相关危险因素者,积极预防,以最大限度地改善患者预后。
Objective To analyze the prognostic factors of 1500 patients with coronary heart disease(CHD) undergoing percutaneous coronary intervention(PCI). Method 1500 CHD patients who underwent PCI in our hospital from December 2014 to July 2017 were enrolled in the study, they were divided into good prognosis group and poor prognosis group according to the occurrence of major adverse cardiac events(MACE). Multivariate Logistic analysis was performed to analyze risk factors affecting the prognosis. Result All of 1500 patients completed one-year follow-up. The incidence of MACE was 16.00%. Multivariate Logistic analysis showed that family history of CHD, combined with diabetes mellitus, left ventricular ejection fraction(LVEF), hematocrit, mean corpuscular volume, red cell distribution width, N-terminal pro-B-type natriuretic peptide(NT-proBNP) and high sensitivity C-reactive proten(hs-CRP) were independent risk factors affecting the prognosis of patients underwent PCI(P_(all)< 0.05). Conclusion Postoperative MACE in CHD patients undergoing PCI is at high risk, we should attach great importance to patients with associated risk factors and actively prevent them so as to improve the prognosis farthest.
Objective To analyze the prognostic factors of 1500 patients with coronary heart disease(CHD) undergoing percutaneous coronary intervention(PCI). Method 1500 CHD patients who underwent PCI in our hospital from December 2014 to July 2017 were enrolled in the study, they were divided into good prognosis group and poor prognosis group according to the occurrence of major adverse cardiac events(MACE). Multivariate Logistic analysis was performed to analyze risk factors affecting the prognosis. Result All of 1500 patients completed one-year follow-up. The incidence of MACE was 16.00%. Multivariate Logistic analysis showed that family history of CHD, combined with diabetes mellitus, left ventricular ejection fraction(LVEF), hematocrit, mean corpuscular volume, red cell distribution width, N-terminal pro-B-type natriuretic peptide(NT-proBNP) and high sensitivity C-reactive proten(hs-CRP) were independent risk factors affecting the prognosis of patients underwent PCI(P_(all)< 0.05). Conclusion Postoperative MACE in CHD patients undergoing PCI is at high risk, we should attach great importance to patients with associated risk factors and actively prevent them so as to improve the prognosis farthest.
引文
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[11]杨帆,王丽,赵洛沙,等.低钠血症对急性心肌梗死经皮冠状动脉介入治疗患者近期预后的影响[J].中华急诊医学杂志,2017,26(3):328-332.
[12]曹丽,安冬梅,石磊,等.急性心肌梗死患者经皮冠状动脉支架植入术术后血清soL-CXCL16及NT-proBNP水平变化分析[J].重庆医学,2017,46(8):1036-1037.
[13]王朋朋.冠心病与NT-proBNP、hs-CRP的相关性研究[J].中国现代医学杂志,2014,24(16):32-35.
[14]吴炯,郭玮,刘晓文,等.C反应蛋白和其他心血管标志物对经皮冠状动脉介入治疗术患者的长期预后作用[J].中华检验医学杂志,2014,37(3):213-218.
[15]陈丰运,肖骅.NT-proBNP、hs-CRP和超声心动图与急性冠状动脉综合征病变程度的相关性研究[J].重庆医学,2015,44(31):4338-4342.
[16]艾民,颜昌福,夏福纯,等.血清hs-CRP及VEGF水平对急性心肌梗死经皮冠状动脉介入治疗术后心血管事件的影响[J].山东医药,2018,58(1):16-18.
[17]沈正,刘兴德,韦波,等.血清超敏C反应蛋白对冠状动脉粥样硬化性心脏病PCI手术患者危险分层与评估预后的价值[J].重庆医学,2018,47(1):54-56.
[2]Lassen JF,Holm NR,Banning A,et al.Percutaneous coronary intervention for coronary bifurcation disease:consensus from the first 10 years of the European Bifurcation Club meetings[J].Eurointervention,2016,12(1):38-46.
[3]Hochgruber T,Reichlin T,Wasila M,et al.Novel insights into the pathophysiology of different forms of stress testing[J].Clin Biochem,2014,47(6):338-343.
[4]Jakimov T,Mrdovi?I,Filipovi?B,et al.Comparison of RISK-PCI,GRACE,TIMI risk scores for prediction of major adverse cardiac events in patients with acute coronary syndrome[J].Croat Med J,2017,58(6):406-415.
[5]Numasawa Y,Kohsaka S,Miyata H,et al.Gender Differences in In-Hospital Clinical Outcomes after Percutaneous Coronary Interventions:An Insight from a Japanese Multicenter Registry[J].PLoS One,2015,10(1):e0116496.
[6]Ducrocq G,Jolly S,Mehta SR,et al.Activated Clotting Time and Outcomes During Percutaneous Coronary Intervention for Non-ST-Segment-Elevation Myocardial Infarction:Insights From the FUTURA/OASIS-8 Trial[J].Circ Cardiovasc Interv,2015,8(4).pii:e002044.
[7]司佳卉,孟若谷,余灿清,等.疾病家族史与冠心病发生风险的关联研究[J].中华流行病学杂志,2018,39(2):173-178.
[8]高晓津,杨进刚,杨跃进,等.中国急性心肌梗死患者心血管危险因素分析[J].中国循环杂志,2015,30(3):206-210.
[9]王慧丽,丁荣晶,黄亚芳,等.影响冠心病患者经皮冠状动脉介入治疗术后死亡率的危险因素分析[J].中华疾病控制杂志,2017,21(2):175-178.
[10]刘新民,董建增,刘小慧,等.红细胞分布宽度对接受择期经皮冠状动脉介入治疗非贫血患者预后的影响[J].中华内科杂志,2016,55(12):937-940.
[11]杨帆,王丽,赵洛沙,等.低钠血症对急性心肌梗死经皮冠状动脉介入治疗患者近期预后的影响[J].中华急诊医学杂志,2017,26(3):328-332.
[12]曹丽,安冬梅,石磊,等.急性心肌梗死患者经皮冠状动脉支架植入术术后血清soL-CXCL16及NT-proBNP水平变化分析[J].重庆医学,2017,46(8):1036-1037.
[13]王朋朋.冠心病与NT-proBNP、hs-CRP的相关性研究[J].中国现代医学杂志,2014,24(16):32-35.
[14]吴炯,郭玮,刘晓文,等.C反应蛋白和其他心血管标志物对经皮冠状动脉介入治疗术患者的长期预后作用[J].中华检验医学杂志,2014,37(3):213-218.
[15]陈丰运,肖骅.NT-proBNP、hs-CRP和超声心动图与急性冠状动脉综合征病变程度的相关性研究[J].重庆医学,2015,44(31):4338-4342.
[16]艾民,颜昌福,夏福纯,等.血清hs-CRP及VEGF水平对急性心肌梗死经皮冠状动脉介入治疗术后心血管事件的影响[J].山东医药,2018,58(1):16-18.
[17]沈正,刘兴德,韦波,等.血清超敏C反应蛋白对冠状动脉粥样硬化性心脏病PCI手术患者危险分层与评估预后的价值[J].重庆医学,2018,47(1):54-56.