早期应用他汀类药物对经皮冠状动脉介入治疗患者预后的影响  

Effect of Early Statins Treatment on Patients with Percutaneous Coronary Intervention in Prognosis

作　　者：赵希哲[1] 马长生[2] 聂绍平[2] 杜昕[2] 吕强[2] 张崟[2] 康俊平[2] 刘新民[2] 刘小慧[2] 

机构地区：[1]北京电力医院心内科,北京100073 [2]首都医科大学附属北京安贞医院心内科

出　　处：《药物流行病学杂志》2008年第2期70-74,共5页Chinese Journal of Pharmacoepidemiology

摘　　要：目的:评价早期应用他汀类药物对行经皮冠状动脉介入治疗(PCI)患者随访结果的影响。方法:选择2001年7月1日～2002年6月30日、2003年7月1日～2004年6月30日在北京安贞医院接受PCI的患者,记录其临床与造影特征、血运重建情况和住院临床结果等。根据住院期间及出院时是否服用他汀类药物,将患者分为他汀组和非他汀组。采用Kaplan-Meier方法、单因素和多因素Cox回归模型分析,观察住院期间及出院时应用他汀类药物对主要不良心血管事件(MACE)及死亡率的影响。采用Cox回归模型分析对死亡、主要不良心血管事件的影响因素。结果:共入选3 289例患者,随访成功3 005例,随访率91.4%。他汀组入选2 082例,非他汀组入选1 207例。随访时间中位数678 d。两组无MACE事件生存率差异有显著性,他汀组发生MACE事件绝对危险性较非他汀组下降7%,相对危险度下降44.3%;两组无全因死亡事件生存率差异有显著性,他汀组全因死亡事件绝对危险性较非他汀组下降0.7%,相对危险度下降23.3%。随访MACE事件的单因素Cox回归分析显示,两组差异有显著性。随访MACE事件的多因素Cox回归分析,两组差异有显著性。随访全因死亡临床结果的单因素Cox、多因素Cox回归分析显示。两组差异有显著性。结论:行经皮冠状动脉介入治疗的患者早期服用他汀类药物可显著减少MACE事件及死亡率。Objective： To evaluate the clinical following-up effect of early statins treatment on patients with percutaneous coronary intervention （PCI） initiated before or at the time of hospital discharge. Method. CAD patients who received revascularization PCI in Beijing Anzhen Hospital from July 1,2001 to June 30, 2002 and July 1,2003 to June 30, 2004. The clinical revascularization characters were recorded. The patients who received successful revascularization were selected, and divided into 2 groups according to whether they received statins therapy before or at the time of hospital discharge ： statins group and non-statins group. Their following-up clinical outcome （ including MACE and mortality） was estimated with Kaplan-Meier method and Cox regression model. The influence of MACE factors and mortality was estimated by Cox regression model. Result： Among 3289 registered patients, the following-up outcomes were successful in 3005 patients （91.4%）. Of the 3289 patients, 2082 patients received statins at or before discharge and 1207 did not. The average fol- low-up periods were 678 days （22.6 months）. Kaplan-Meier analysis revealed that the cumulative MACE free survival rate was lower in no-statins group than in statins group. The incidence of MACE in statins group was 7% lower than that in no-statins group with a reduction of relative risk by 44.3%. Kaplan-Meier analysis revealed that the cumulative survival rate was lower in no-statins group than in statins group. The all-cause mortality in statins group was 0.7% lower than that in no- statins group with a reduction of relative risk by 23.3%. In single-variate Cox regression analysis, the incidence of MACE in two groups had their statistical significance, in multi-variate Cox regression analysis, the incidence of MACE in two groups had their statistical significance, and in single-variate Cox regression analysis and multi-variate Cox regression analysis, all-cause mortality in two groups also had their statistical significance. Conclusion： Ear

关 键 词：他汀类药物 介入治疗 预后 不良心血管事件 

分 类 号：R972.6[医药卫生—药品]