应用SYNTAX积分预测多支病变冠心病患者支架植入后长期预后的价值  

Predictive value of SYNTAX score in long-term prognosis in patients with coronary multiple-vessel disease receiving percutaneous coronary intervention

作　　者：何小萍[1] 苏少辉[1] 黎志云[1] 吴秀英[1] 

机构地区：[1]东莞市人民医院心血管内科,广东东莞523000

出　　处：《岭南心血管病杂志》2016年第4期419-423,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的评估冠状动脉造影SYNTAX积分在预测多支病变冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗长期预后的临床应用价值。方法选择东莞市人民医院160例经冠状动脉造影(CAG)诊断为多支病变并接受PCI治疗的冠心病患者,依据冠状动脉造影SYNTAX积分将患者分为3组:高分值组,共51例,SYNTAX积分大于33分;中分值组,共64例,SYNTAX积分为23-32分;低分值组,共45例,SYNTAX积分小于23分。随访3年,记录并比较3组患者主要不良心脑血管事件(major adverse cardiac and cerebral vascular events,MACCE)发生率。根据MACCE发生情况将患者分为发生组与未发生组,比较两组患者各临床因素的差异。通过计算机COX比例风险模型,对PCI治疗预后可能产生影响的特征性因素进行多因素分析。结果高分值组的MACCE发生率显著高于中分值组与低分值组,差异有统计学意义(P<0.05);且中分值组大于低分值组,差异有统计学意义(P<0.05)。应用COX比例风险模型预测MACCE发生的单因素及多因素分析均显示,SYNTAX积分和糖化血红蛋白均是MACCE发生的独立危险预测因子(P<0.05)。结论冠状动脉造影SYNTAX积分能有效预测多支病变冠心病患者PCI治疗后长期预后结局,临床价值理想。Objectives To evaluate the predictive value of SYNTAX score in long-term prognosis in patients with coronary multiple-vessel disease （MVD） receiving percutaneous coronary intervention （PCI）. Methods Totally 160 patients diagnosed as MVD by coronary angiography （CAG） in Dongguan People＇s Hospital receiving PCI were collected and were divided into three groups according to the SYNTAX score after CAG, which were high-score group （51 cases, SYNTAX score was higher than 33）, medium-score group （64 cases, SYNTAX score ranged from 23 to 32） and low- score group （45 cases, SYNTAX score was lower than 23）. After following up for 3 years, the occurrences of major adverse cardiac and cerebral vascular events （MACCE） were recorded and compared among the three groups. All the patients were divided into two groups based on the occurrence of MACCE, which were occurring group and non- occurring group. The clinical factors were compared between the two groups. An univariate and multivariate analysis of these individual variables was applied to patients with MVD receiving PCI by computer COX proportional hazards model. Results Occurrence of MACCE in high-score group was the highest among the three groups （P〈0.05）, and occurrence of MACCE in medium-score group was higher than that in low-score group （P〈0.05）. SYNTAX score and hemoglobin Alc were the independent risk factors of occurrences of MACCE （P〈0.05） indicated by computer COX proportional hazards model. Conclusions SYNTAX score can forecast the long-term prognosis in patients with MVD receiving PCI, and the clinical value of SYNTAX score is satisfactory.

关 键 词：冠状动脉疾病 血管成形术 经腔 经皮冠状动脉 SYNTAX积分 主要不良心脑血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]