影响冠心病患者PCI手术预后相关因素分析  

Analysis of risk factors affecting prognosis of percutaneous coronary intervention in patients with coronary heart disease

作　　者：李春燕[1] 高明霞[1] 麻朴[1] 钟文杰[1] 

机构地区：[1]河南科技大学第一附属医院心脏病科,471003

出　　处：《江苏医药》2014年第7期822-824,共3页Jiangsu Medical Journal

摘　　要：目的分析冠心病(CHD)患者行经皮冠状动脉介入术(PCI)治疗预后,探讨影响预后的相关因素。方法回顾性分析300例行PCI的CHD患者临床资料。随访6个月,记录预后情况。随访期间3例心源性死亡,非致死性心肌梗死7例,充血性心力衰竭16例,不稳定心绞痛42例,再次PCI治疗12例,为预后差组(B组,80例);未发生上述情况者为预后好组(A组,220例)。采用非条件Logistic回归分析进行危险因素分析。结果高血脂症、高血压病、糖尿病、病变血管数和采用的支架类型均与其预后密切相关(P<0.05或P<0.01)。高血脂症(OR=2.012,95%CI=1.101-3.676,P<0.05)及金属裸支架(OR=2.942,95%CI=1.101-7.861,P<0.05)是影响CHD患者心脏介入治疗预后的独立危险因素。结论 CHD患者PCI术后的预后与高血脂症、高血压病史、糖尿病史、病变血管数和采用的支架类型密切相关。高血脂症和金属裸支架是影响CHD患者心脏介入治疗预后的独立危险因素,PCI手术前后应对高脂血症进行积极控制,并尽可能选择药物涂层支架。Objective To analyze the risk factors for the prognosis of patients with coronary heart disease（CHD） underwent percutaneous coronary intervention（PCI）. Methods Data of 300 CHD patients underwent PCI were retrospectively analyzed. The patients were followed up for 6 months, during which cardiogenic death occurred in 3 cases, nonfatal myocardial infarction in 7 cases, congestive heart failure in 16 cases, unstable angina in 42 cases, and PCI treatment for the second time in 12 cases. A total of 80 cases mentioned above was assigned into poor prognosis group（B） and those without above events were put in good prognosis group（A）. The unconditioned Logistic regression analysis was performed for detecting the risk factors for poor prognosis. Results The hyperlipidemia, hypertension, diabetes,lesion vessel number, and type of metal stents were the factors closely related to the prognosis（P〈0. 05 or P〈0. 01）, of which hyperlipidemia（OR= 2. 012,95 %CI= 1. 101-3. 676, P〈0. 05） and metal stents（OR= 2. 942,95 % CI = 1. 101-7. 861, P〈0. 05） were the independent risk factors for the poor outcomes of CHD patients after PCI. Conclusion Hyperlipidemia, hypertension, diabetes,lesion vessel number, and type of metal stents are closely related to the prognosis of CHD patients after PCI. Hyperlipidemia and metal stents are the independent risk factors for cardiac events after PCI and attention should be paid to controlling hyperlipidemia before and after PCI and selecting drug-coated stents.

关 键 词：冠心病 经皮冠状动脉介入术 

分 类 号：R541[医药卫生—心血管疾病]