行血运重建的UAP／NSTEMI患者院内预后的影响因素  

Predictive factors for in-hospital cardiac adverse events for unstable angina pectoris or non-ST elevated myocardial infarction undergoing revascularization

作　　者：吕强[1] 康俊萍[1] 杜昕[1] 聂绍平[1] 胡荣[1] 张崟[1] 韩智红[1] 王甦[1] 郝蓬[1] 刘彤[1] 何继强[1] 梁金鑫[1] 董建增[1] 刘小慧[1] 马长生[1] 

机构地区：[1]北京首都医科大学附属北京安贞医院心内科,北京100029

出　　处：《中国医师杂志》2007年第3期326-328,共3页Journal of Chinese Physician

摘　　要：目的探讨不稳定心绞痛（UA）或非ST段抬高心肌梗死（NSTEMI）住院患者行血运重建后院内不良事件的发生率及影响因素。方法SUNDAY注册（The Strategies for UA／NSTEMI and Delay of Angioplasty RegistrY）研究为单中心回顾性登记研究，入选2000年1月～2002年12月间首次因UA／NSTEMI在本院住院的患者，选择行血运重建的患者，分析住院期间的心性不良事件和影响因素。结果共入选1013例患者，其中742例行血运重建，男性559例（75．3％），女性183例。年龄（60．03±10．03）岁，住院期间31例（4．2％）发生心性不良事件。对包括性男q、年龄、高血压史、糖尿病史、入院心率、收缩压、空腹血糖、血肌酐、低密度脂蛋白、血白细胞计数、左室射血分数（LVEF）、冠状动脉病变程度、入院距血运重建时间和是否完全血运重建在内的多因素Logistic回归分析显示，LVEF越高，院内不良事件发生越低（OR0．958，95％C10．921-0．997，P=0．034）；血白细胞计数升高，不良事件发生率越高（OR1．238，95％CI1．042—1．472，P=0．015）；冠脉病变越重（分为单支、双支、三支3组），不良事件发生越多（OR2．255．95％CI 1．172-4，342，P=0．015）。结论UA和NSTEMI住院患者行血运重建后院内心性不良事件发生率较低，血白细胞计数、低LVEF和冠状动脉病变的程度是院内不良顸后的独立预测因素。Ojective To assess the risks for in-hospital main cardiac adverse events for the entire spectrum of unstable angina pectoris or non-ST elevated myocardial infarction undergoing revascularization in general clinical practice. Methods SUNDAY （The Strategies for UA/NSTEMI and Delay of Angioplasty RegistrY）was a retrospective registry, which patients admitted with UA/NSTEMI from January ,2000 to December, 2002. A multivariable logistic regression model was developed using 742 patients with ACS without ST-segment elevation undergoing revascularization. Results A total of 1013 patients were recruited, 742 patients undergoing revascularization, 559 patients （75. 3% ） were male, the mean age was 60. 03 ± 10. 03. MACE were happened in 31 patients （4. 2% ） The following 3 independent risk factors accounted for the prognostic information： LVEF （odds ratio [ OR ], 0. 958,95% CI 0. 921 -0. 997, P =0. 034）, white blood cell count （OR, 1. 238,95% CI 1. 042 - 1. 472, P = 0. 015 ）, and number of diseased vessels （ OR 2. 255,95% CI 1. 172 - 4,342, P = 0. 015）. Conclusions LVEF, white blood cell count and number of diseased vessels were independent risk factors for in-hospital MACE in UA/NSTEMI patients undergoing revascularization.

关 键 词：心绞痛 不稳定型 心肌梗死 血管外科手术 预后 

分 类 号：R541[医药卫生—心血管疾病] R542[医药卫生—内科学]