颈动脉斑块逆转程度在评估急性冠脉综合征介入治疗近期预后中的价值  

Value of reversal degree of carotid plaque in evaluating short-term prognosis of patients with acute coronary syndrome after percutaneous coronary intervention

作　　者：倪杰[1] 曹东来[1] 何文兵[1] 何俊[1] 童廉琦[1] 赵品君 王娟[1] 王志松[1] 韩冷[1] 

机构地区：[1]常熟市第一人民医院心血管病科,江苏省215500

出　　处：《江苏医药》2016年第11期1250-1254,共5页Jiangsu Medical Journal

摘　　要：目的探讨颈动脉斑块逆转程度在评估急性冠脉综合征(ACS)患者行经皮冠状动脉介入(PCI)治疗近期预后中的价值。方法将180例行PCI治疗的ACS患者分为颈动脉斑块明显逆转组(A组,88例)和无明显逆转组(B组,92例)。观察两组术后主要不良心血管事件(MACE)的发生情况,并分析其与颈动脉斑块逆转程度的关系。结果两组患者手术前后BMI以及生化指标比较均无统计学差异(P>0.05)。与B组相比,A组斑块面积和术后随访1年的MACE发生率减少[(48.3±22.7)mm^2 vs.(57.2±33.9)mm^2和18.2%vs.32.6%](P<0.05)。Cox多因素分析显示,斑块面积下降率是ACS患者PCI术后发生MACE的独立保护因素[RR=0.000,95%CI(0.000~0.090),P<0.05]。结论 PCI术后颈动脉斑块明显逆转的ACS患者的MACE发生率更低,预后更好。Objective To investigate the value of reversal degree of carotid plaque in evaluating the short-term prognosis of patients with acute coronary syndrome（ACS）after percutaneous coronary intervention（PCI）.Methods A total of 180 patients with ACS underwent PCI treatment was divided into two groups of A（obvious reversal of carotid plaque,88cases）and B（unchanged reversal of carotid plaque,92cases）.The major adverse cardiovascular events（MACE）were observed after surgery,and the relationship between MACE and reversal degree of carotid plaque was analyzed.Results There were no statistical differences in BMI and biochemical indexes before and after surgery between groups of A and B（P〉0.05）.Compared with group B,the plaque area and incidence of MACE after 1-year follow-up were decreased in group A[（48.3±22.7）mm^2 vs.（57.2±33.9）mm^2 and 18.2% vs.32.6%]（P〈0.05）.Cox multivariate analysis showed that the decrease rate of plaque area was an independent protection factor for MACE in ACS patients after PCI[RR=0.000,95%CI（0.000-0.090）,P〈0.05].Conclusion The ACS patients with obvious reversal of carotid plaque after PCI have lower incidence of MACE and better prognosis.

关 键 词：急性冠脉综合征 经皮冠状动脉介入 颈动脉斑块 心血管事件 

分 类 号：R541[医药卫生—心血管疾病]