急性冠状动脉综合征预后及相关因素的单中心研究  

Prognosis of patients with acute coronary syndrome and its relevant factors

作　　者：康琳[1] 管文娟[2] 刘晓红[1] 严晓伟[2] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院老年医学科,100730 [2]中国医学科学院北京协和医学院北京协和医院心内科

出　　处：《中华老年心脑血管病杂志》2012年第11期1158-1161,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的分析急性冠状动脉综合征(ACS)患者出院后再发心脑血管事件与其危险因素、治疗状况的相关性。方法选择ACS患者634例,采取门诊随诊、信访、电话和身份证查找的方法进行随访。失访21例,最终共随访613例。随访内容包括再发心脑血管事件、每年随诊次数、随诊时心率、冠心病二级预防用药情况等。采用多元回归分析各因素对预后的影响。结果平均随访61个月时,年龄(P=0.026)、随诊时心率(P=0.001)、坚持随诊次数(P=0.002)及是否坚持服用冠心病二级预防药物(P=0.000)与再发心脑血管事件相关。logistic多元回归分析显示,年龄、体重指数、每天吸烟支数、糖尿病史、随诊时心率对再发心脑血管事件有独立预测价值。生存分析结果显示,第1年至第8年随诊累积无事件存活率分别为88%、82%、78%、74%、71%、68%、66%及65%;风险率分别为13%、7%、6%、5%、4%、4%、3%及1%。结论 ACS住院患者出院后1年内出现再发心脑血管事件的风险明显高于其他时间段,长期、规律的临床随诊可以减少心脑血管事件的发生。Objective To analyze the correlation of cardio-cerebral vascular events in patients with acute coronary syndrome（ACS） after discharge with their risk factors and treatment outcome. Methods Of the 634 ACS patients included in this study,613 were followed up,21 missed their follow-up. The follow-up parameters included recurrence of cardio-cerebral vascular events, annual follow-up times, heart rate at follow-up, and drugs used in second class prevention of coronary heart disease. Effect of different factors on prognosis of ACS patients was analyzed by multivari- ate logistic regression analysis. Results The patients were followed up for 61 months. The age, heart rate, follow-up times, and drugs used in second class prevention of coronary heart disease were related with the recurrence of cardio-cerebral vascular events（P%0.05）. Multivariate logis- tic regression analysis showed that the age,BMI,number of smoked cigarretes per day, history of diabetes mellitus,and heart rate at follow-up were the independent factors for the reccurrence of cardio-cerebral vascular events. Survival analysis revealed that the cardio-cerebral vascular events- free survival rate was 88%, 82%, 78%, 74%, 71%, 68%, 66%, and 65%, respectively, and the mortality rate was 13%,7%,6%,5%,4%,4%,3% and 1%,respectively,in the 1--8 years fol- low-up. Conclusion The risk to reccur cardio-cerebral vascular events in ACS patients is signifi- cantly greater at 1 year after discharge than at other time points. Long-term and regular follow-up can reduce the recurrence of cardio-cerebral vascular events.

关 键 词：急性冠状动脉综合征 随访研究 危险因素 预后 

分 类 号：R541.4[医药卫生—心血管疾病]