术前收缩期射血时间对冠心病合并心力衰竭患者冠脉搭桥术短期预后的影响  

The effect of preoperative systolic ejection time on short-term prognosis of coronary artery bypass grafting in coronary heart disease patients with heart failure

作　　者：叶丹 张光清[2] 吴海燕[1] YE Dan;ZHANG Guang⁃qing;WU Hai⁃yan(Department of Ultrasonic Medicine,Sinopharm Dongfeng General Hospital of Hubei University of Medicine,Shiyan,Hubei 442008,China;Department of Cardiovascular Surgery,Sinopharm Dongfeng General Hospital of Hubei University of Medicine,Shiyan,Hubei 442008,China)

机构地区：[1]湖北医药学院附属国药东风总医院超声医学科,湖北十堰442008 [2]湖北医药学院附属国药东风总医院心胸大血管外科,湖北十堰442008

出　　处：《热带医学杂志》2022年第12期1711-1714,1718,共5页Journal of Tropical Medicine

基　　金：湖北省卫生健康委指导性项目(WJ2021F051)

摘　　要：目的探讨术前收缩期射血时间(SET)对冠心病合并心力衰竭患者冠脉搭桥术(CABG)短期预后的影响。方法选取2017年9月-2019年7月湖北医药学院附属国药东风总医院收治的132例冠心病合并射血分数降低的心力衰竭(HFrEF)患者作为研究对象,所有患者均行CABG,并在术前24 h内行床旁超声心动图检查,测得SET。以术后2年内是否发生主要不良心脏事件(MACE)将其分为不良事件组(n=60)和无事件组(n=72)。以术前SET中位数(277.5 ms)将其分为SET缩短组(n=66)和SET无缩短组(n=66)。分析术前SET与CABG短期预后的关系,并比较不同术前SET水平患者围术期术后并发症。结果不良事件组入院时心率较无事件组快,术前SET较无事件组短,差异均有统计学意义(P均<0.05)。SET缩短组和SET无缩短组临床资料各指标差异均无统计学意义(P均>0.05)。Logistic回归分析结果表明,冠心病合并HFrEF患者较长的术前SET与CABG术后2年MACE发生的减少相关(OR=0.973,95%CI:0.955~0.992)。SET缩短组和SET无缩短组患者围术期术后并发症发生率差异均无统计学意义(P均>0.05)。结论冠心病合并HFrEF患者术前SET缩短可增加CABG术后MACE的发生率,是CABG短期预后的重要危险因素,可作为一项预后指标,为临床治疗选择、预后判断提供参考。Objective This paper aimed to study the relationship between preoperative systolic ejection time(SET)and short-term prognosis of coronary artery bypass grafting(CABG)in coronary heart disease patients with heart failure.Methods A total of 132 coronary heart disease patients who were hospitalized for heart failure with reduced ejection fraction(HFrEF)in the Sinopharm Dongfeng General Hospital of Hubei University of Medicine from September 2017 to July2019 were selected as the study subjects.All patients underwent CABG and preoperative SET was obtained with bedside echocardiography within 24 hours before surgery.According to the occurrence of major adverse cardiac events(MACE)within two years after surgery,they were divided into adverse event group(n=60)and event-free group(n=72).According to preoperative SET’s median(277.5 ms),they were divided into SET shortening group(n=66)and SET no shortening group(n=66).The relationship between preoperative SET and short-term prognosis of CABG was analyzed and perioperative period postoperative complications were compared between patients with different preoperative SET level.Results Heart rate at admission of adverse event group was significantly faster than event-free group and preoperative SET of adverse event group was significantly shorter than event-free group(P all<0.05).Comparison of clinical date of patients between SET shortening group and SET no shortening group showed that there were no statistically significant differences(P all>0.05).The results of logistic regression analysis showed that longer preoperative SET in coronary heart disease patients with HFrEF was associated with decrease of two-year MACE occurrence after CABG(OR=0.973,95%CI:0.955-0.992).Incidence of perioperative period postoperative complications between SET shortening group and SET no shortening group were compared,and the results showed that there were no statistically significant differences(P all>0.05).Conclusion sReducing preoperative SET in coronary heart disease patients with HFrEF could

关 键 词：收缩期射血时间 冠脉搭桥术 冠心病 预后 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]