血清肌酐水平与左房内径对急性冠脉综合征患者PCI术后远期预后预测的附加价值  

Added value of serum creatinine level and left atrial diameter in predicting long-term prognosis of PCI for acute coronary syndrome

作　　者：王静 赵琳 王皓 Wang Jing;Zhao Lin;Wang Hao(Department of Cardiology,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China)

机构地区：[1]郑州大学附属洛阳中心医院心内科,河南洛阳471000

出　　处：《临床医学》2022年第9期5-8,共4页Clinical Medicine

基　　金：河南省医学科技攻关计划(LHGJ20210854)

摘　　要：目的探讨血清肌酐(Scr)水平和左房内径(LAD)对急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)术后远期预后预测的附加价值。方法选取2017年1月至2017年6月郑州大学附属洛阳中心医院出院的ACS并行PCI的939例患者为研究对象,进行3年随访。将随访期间发生主要心脏不良事件(MACEs)的203例患者纳入MACEs组。其余736例未发生MACEs的患者纳入Non-MACEs组。按照基线水平的血肌酐(Scr)值将患者分为Scr低值组(Scr<68μmol/L)和Scr高值组(Scr≥68μmol/L)。比较MACEs组与Non-MACEs组患者的临床资料。评估基线水平的Scr和LAD与MACEs的相关性。应用多变量COX回归分析来计算危险比(HR)。结果MACEs组Scr水平[74.5(59.0-91.5)μmol/L]明显高于Non-MACEs组[67.0(57.0~78.0)μmol/L],差异有统计学意义(P<0.001)。与Non-MACEs组相比,MACEs组LAD值较高(P=0.01)。在多变量分析中,Scr水平是MACEs的重要预测因素(HR 1.015,95%CI 1.003~1.026,P<0.05)。肌酐高值组的LAD(P<0.001)显著高于肌酐低值组。结论ACS患者PCI术后发生MACEs的患者中,Scr水平和LAD值较高。Scr可用作ACS患者PCI术后的远期预后标志物,LAD值对ACS患者预后的评估具有附加价值。Objective To investigate the added value of serum creatinine(Scr)and left atrial diameter(LAD)in predicting the long-term prognosis of PCI for acute coronary syndrome(ACS).Methods A total of 939 patients with ACS and PCI discharged from Luoyang Central Hospital Affiliated to Zhengzhou University from January 2017 to June 2017 were selected as the research objects,and followed up for 3 years.The 203 patients with major adverse cardiac events(MACEs)during follow-up were included in the MACEs group.The remaining 736 patients without MACEs were included in the non MACEs group.The patients were divided into low Scr group(Scr<68μmol/L)and high Scr group(Scr≥68μmol/l)according to the baseline Scr value.The clinical data of patients in MACEs group and non MACEs group were compared.The correlation between baseline Scr and LAD and MACEs was evaluated.Multivariate Cox regression analysis was used to calculate the hazard ratio(HR).Results The Scr level of patients in MACEs group[74.5(59.0-91.5)μmol/L]was significantly higher than that of patients in non MACEs group[67.0(57.0-78.0)μmol/L],there was significant difference(P<0.001).Compared with patients in non MACEs group,the patients in MACEs group had higher LAD value(P=0.01).In multivariate analysis,Scr level was an important predictor for MACEs(HR 1.015,95%CI 1.003-1.026,P<0.05).The levels of LAD in high creatinine group was significantly higher than that in low creatinine group(P<0.001).Conclusions In ACS patients with MACEs after PCI,the levels of Scr and LAD are higher.Scr is used as a long-term prognostic marker for ACS patients after PCI.Left atrial diameter has additional value in improving the prognosis of ACS patients.

关 键 词：急性冠脉综合征 经皮冠状动脉介入治疗 心血管风险 肌酐 左房内径 

分 类 号：R541.4[医药卫生—心血管疾病]