体质量指数对非ST段抬高急性冠状动脉综合征患者血运重建的影响  

Impact of bodyweight to clinical outcomes in NSTE-ACS patients undergoing coronary revascularization

作　　者：康俊萍[1] 马长生[1] 吕强[1] 聂绍平[1] 刘新民[1] 刘小慧[1] 杜昕[1] 胡荣[1] 张崟[1] 董建增[1] 吴学思[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,北京100029

出　　处：《心肺血管病杂志》2011年第2期103-106,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点基础研究发展计划(973计划)课题编号:2003CB517103

摘　　要：目的:了解体质量指数(BMI)对非ST段抬高急性冠状动脉综合征患者血运重建治疗后的预后影响。方法:以DESIRE Ⅱ(The second drug-eluting stent impact on revascularization registry Ⅱ)为单中心回顾性注册研究,入选2003年7月1日至2005年9月30日在我院接受血运重建治疗的6 005例患者,2006年9月1日至11月30日对患者进行电话或门诊随访。本研究入选其中有体质量指数资料的非ST段抬高急性冠状动脉综合征病例3 001例。将这些患者按BMI分为2组,体质量指数(BMI)<23组和BMI≥23组,比较2组之间的临床情况和预后情况。不良心脑血管事件(MACCE)包括全因死亡、非致死性心肌梗死、非致死性卒中和再次血运重建。结果:共3 001例患者,BMI<23组506例和BMI≥23组2 495例,与BMI<23组的患者相比,BMI≥23组的患者年龄较小,伴随危险因素(高血压、糖尿病和高脂血症)较多,完全血运重建率低,总病死率低[HR 0.461,95%CI 0.262～0.808],2组心血管病死率和总MACCE发生率差异无统计学意义。结论:在非ST段抬高急性冠状动脉综合征患者中,尽管BMI≥23组相对BMI<23者有更多的危险因素,但是接受血运重构治疗后的总病死率低。Objective：The goal of this study was to determine the association of bodyweight with clinical outcomes in NSTE-ACS patients undergoing coronary revascularization.Methods：The DESIRE Ⅱ（Drug-Eluting Stent Impact on Revascularization Ⅱ） was a single-center registry of coronary revascularization in our institution between July 2003 and Sep.2009.We analyzed non ST elevated acute myocardial syndrome（NSTE-ACS） patients with complete data of demography,clinical,revascularization recovds from the DESIRE Ⅱ trial,grouped by body mass index（BMI）,which were divided into 2 groups（〈23 and 23 or more）.The patients were followed up by telephone after discharge.MACCE including death,neo-myocardial infarction,stroke,re-revascularization were recorded.We evaluated clinical outcomes of the two group patients.Results：The study included 6005 patients,with a median follow-up of 566 days.3001 NSTE-ACS patients were analyzed.Patients with higher BMI（≥23） were younger than those with lower BMI（〈23）,had more risk factors（hyperten-sion,diabetes mellitus and hyperlipemia）,and the total revascularization rate was lower.Patients with a low BMI had increased risk ratio for total mortality（HR 0.461,95% CI 0.262-0.808） compared with those for patients with higher BMI.There was no significant difference for cardiovascular death and MACCE between different BMI groups.Conclusion：The NSTE-ACS patients with higher BMI underwent revascularization had betteroutcome for total mortality.

关 键 词：体质量指数 急性冠状动脉综合征 非ST段抬高 血运重建 预后 

分 类 号：R541.4[医药卫生—心血管疾病]