残余SYNTAX积分对急性冠脉综合征患者介入治疗后远期临床结局的预测价值  

Impact of residual SYNTAX score on long-term clinical outcomes after percutaneous coronary intervention in patients with acute coronary syndrome

作　　者：安丽丽[1] 张新梅[1] 黄文正[1] AN Li-li;ZHANG Xin-mei;HUANG Wen-zheng(Department of Internal Medicine, Hebei Central Energy Fengfeng Group General Hospital, Hebei, Handan 056002, Chin)

机构地区：[1]冀中能源峰峰集团总医院邯郸院区内一科,河北邯郸056002

出　　处：《岭南心血管病杂志》2018年第2期141-145,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的分析残余SYNTAX积分对急性冠脉综合征患者介入治疗后远期临床结局的预测价值。方法本研究为回顾性观察研究,连续纳入自2008年1月至2013年12月于冀中能源峰峰集团总医院行介入治疗的1 191例急性冠脉综合征患者。根据残余SYNTAX积分(residual SYNTAX score,rSS)结果分为3组:低rSS组、中rSS组、高rSS组。我们对患者的基线资料、介入治疗资料以及两年的随访结果进行比较。结果高rSS组的死亡加心肌梗死的复合终点发生率明显高于低rSS组和中rSS组,差异有统计学意义(P<0.05)。3组之间血运重建发生率逐步增高(9.2%vs.19.6%vs.23.8%),联合事件终点的发生率也逐步增加(14.5%vs.23.8%vs.31.5%),差异均有统计学意义(P<0.05)。Kaplan-Meier生存曲线显示3组之间随着rSS的增加,联合事件终点发生率明显增加(P=0.000)。多因素Cox分析表明残余SYNTAX积分是影响远期预后的独立危险因素,其他独立影响远期预后的因素包括高脂血症,介入治疗成功和应用糖蛋白Ⅱb/Ⅲa受体拮抗剂。结论 rSS可以量化介入治疗后的残余狭窄程度,而且是影响急性冠脉综合征患者介入治疗后远期预后的独立预测因素,随着rSS的增加,联合事件终点的发生率也逐步增加。Objectives To evaluate whether residual SYNTAX score（rSS）affects the long-term outcomes of patientswith acute coronary syndrome（ACS）undergoing percutaneous coronary intervention（PCI）. Methods Between January2008 and December 2013,1 191 consecutive patients with ACS admitted to Hebei Central Energy Fengfeng GroupGeneral Hospital and underwent PCI were enrolled in this study. Accordingly to rSS,patients were divided in low rSS group,mid rSS group and high rSS group. Results Incidence of death and myocardial infarction composite end pointswas significantly higher in high rSS group compared to low rSS group and mid rSS group. As rSS increased,incidencesof revascularization（9.2% vs. 19.6% vs. 23.8%）and joint event end（14.5% vs. 23.8% vs. 31.5%）grandly increasedamong the 3 groups（P0.05）. Kaplan-Meier survival curves showed that as rSS increased,incidence of joint event endincreased. In multivariate COX analysis,the independent predictors of long-term prognosis were rSS,hypercholesterol-emia,successful PCI,usage of glycoprotein IIb/IIIa. Conclusions The rSS is useful to quantify and risk-stratify thedegree and complexity of residual stenosis after PCI in patients with ACS. And rSS is an independently predictor oflong-term outcomes in patients with ACS undergoing PCI.

关 键 词：冠状动脉疾病 残余SYNTAX积分 血管成形术 经腔 经皮冠状动脉 

分 类 号：R541.4[医药卫生—心血管疾病]