冠心病患者左心功能不全对冠状动脉介入术预后影响  

Effect of left ventricular dysfunction on prognosis of postoperative patients with coronary heart disease

作　　者：赵莹莹[1] 王效增[1] 王斌[1] 孙蕾[1] 张磊[1] 周鹤[1] 李智[1] 

机构地区：[1]沈阳军区总医院心血管内科,辽宁沈阳110016

出　　处：《临床军医杂志》2017年第11期1118-1121,共4页Clinical Journal of Medical Officers

基　　金：国家临床重点专科军队建设项目资助;国家"十三五"重点研发计划项目(2016YFC1301300)

摘　　要：目的探讨左心功能不全的冠心病患者临床特点,评价左心功能不全对冠心病患者行经皮冠状动脉介入术(PCI)预后的预测作用。方法回顾性分析沈阳军区总医院心血管内科自2011年1月至2014年7月经冠脉造影明确诊断并行PCI的24 627例冠心病患者,按左心室射血分数(LVEF)值分为左心功能不全组(LVEF<50%)2 182例和左心功能正常组(LVEF≥50%)22 445例,比较两组间的基线资料和PCI术后30 d及12个月主要不良心脑血管事件(MACCE)发生率。应用Logistic多因素回归分析法评估冠心病左心功能不全患者对PCI术后30 d及12个月的MACCE事件发生率的预测价值。结果术后30 d,左心功能不全组患者PCI的MACCE事件发生率显著高于左心功能正常组(2.4%比0.5%,P<0.01);术后12个月,左心功能不全组也高于左心功能正常组(6.6%比2.6%,P<0.01)。Logistic回归分析显示,LVEF值<50%为MACCE的独立预测因素。结论左心功能不全是PCI术后30 d及12个月发生MACCE的预测因素。Objective To investigate the clinical characteristics of patient with coronary heart disease and left ventricular dysfunction,and evaluate the prognosis of percutaneous coronary intervention（PCI）.Methods A retrospective study was performed on 24 627 cases of patients who were diagnosed as coronary heart disease and underwent PCI from January 2011 to July 2014.According to the left ventricular ejection fraction（LVEF） value,patients were divided into the left ventricular dysfunction group（LVEF less than 50%） with2 182 cases and the left ventricular normal function group（LVEF more than 50%） with 22 445 cases.Baseline data and the incidence rate of major adverse cardiovascular and cerebrovascular events（MACCE） 30 days and 12 months after PCI were compared between the two groups.Logistic multivariate regression analysis was used to evaluate the predictive value of the incidence rate of MACCE events30 days and 12 months after PCI.Results The incidence rate of MACCE 30 days after PCI in the left ventricular dysfunction group was significantly higher than that of the normal left ventricular function group（2.4% versus 0.5%,P〈0.01）;the incidence rate of MACCE 12 months after PCI in the left ventricular dysfunction group was higher than that of the normal left ventricular function group（6.6% versus 2.6%,P〈0.01）.Logistic regression analysis showed that the LVEF value less than 50% was the independent predictor of MACCE.Conclusion Left ventricular dysfunction is one predictor of MACCE 30 days and 12 months after PCI.

关 键 词：冠心病 经皮冠状动脉介入术 左心功能不全 主要不良心脑管事件 预后 

分 类 号：R541.4[医药卫生—心血管疾病]