急性冠脉综合征患者PCI术预后的多因素分析  

Multivariate analysis of patients with acute coronary PCI patients prognosis syndrome

作　　者：王炳华[1] 孙桂芳[1] 

机构地区：[1]滨州市中心医院心血管内科,山东251700

出　　处：《社区医学杂志》2015年第17期19-21,共3页Journal Of Community Medicine

摘　　要：目的探究影响急性冠脉综合征患者接受经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）的预后的相关因素,从而临床医疗决策提供循证依据。方法连续纳入2012年6月—2014年6月入住本院心内科急性冠脉综合征并接受PCI患者200例。手术后对患者随访30 d,记录手术前后患者的病史、疾病类型、治疗药物及治疗手段,采用Cox危险因素回归分析各影响因素与终点事件的关系。P〈0.05为差异有统计学意义。结果急性冠脉综合征患者PCI预后与年龄、性别、急性冠脉综合征类型、心功能分级、入院24 h休克、入院时LDL-C、手术后肾功能不全有关（P〈0.05）。年龄的OR值为1.043,其95%CI为1.001~1.124;性别的OR值为2.141,其95%CI为1.349~3.667;急性冠脉综合征类型的OR值为3.124,其95%CI为1.497~6.741;心功能分级的OR值为1.779,其95%CI为1.349~2.01;入院24 h休克的OR值为6.021,其95%CI为3.496~9.364;肾功能不全OR值为3.011,其95%CI为1.997~5.231。入院时高LDL-C水平是保护因素,其OR值为0.346,其95%CI为0.213~0.679,余者均为危险因素。结论我们应综合考量患者情况,从而制定真正有益患者预后的诊疗方案。Objective To explore the risk factors of the prognosis of patients who were with ACS and were underwent PCI.Methods From June 2012 to June 2014,200 patients with ACS who were underwent PCI in our hospital were included in our study.They were followed up for 30 days.The demographic characters,physical condition,disease history,the type of ACS and the interventions of ACS patients were record in detail.Cox regression were performed to analyze the relationship between the adverse events and other risk factors,P〈0.05 were significant differences.Results There are relationships between adverse events and age,sex,the types of ACS,cardiac function classification,shock occurring within 24 h, renal dysfunction and the level of LDL- C.The OR of age is 1.043,with 95%CI（1.001~1.124）.The OR of sex is 2.141,with 95%CI（1.349~3.667）.The OR of the types of ACS is3.124,with 95%CI（1.497~6.741）.The OR of cardiac function classification is 1.779,with 95%CI（1.349~2.01）.The OR of shock occurring within 24 h is 6.021, with 95%CI（3.496~9.364）.The OR of renal dysfunction is 3.011,with 95%CI（1.997~5.231）.The OR of level of LDL- C is 0.346,with 95%CI（0.213~0.679）.Only high level of LDL- C is a protective factor.Conclusion We should consider the profile of patients in all aspects with thinking of the influence and the effects of the factors above, and make the treatment plan good for patient prognosis.

关 键 词：急性冠脉综合征 经皮冠状动脉介入治疗 预后 多因素分析 

分 类 号：R541.4[医药卫生—心血管疾病]