血清γ-谷氨酰转移酶水平与老年冠心病患者经皮冠状动脉介入治疗后远期死亡率的关系  

Association Between Serum Gamma-glutamyl Transferase and Long-term Mortality in Elderly Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

作　　者：王乐 周玉杰[2] 丛洪良[1] 胡越成[1] 张敬霞[1] 张迎怡[1] WANG Le;ZHOU Yu-jie;CONG Hong-liang;HU Yue-cheng;ZHANG Jing-xia;ZHANG Ying-yi(Department of Cardiology,Tianjin Chest Hospital,Tianjin（300000）,China)

机构地区：[1]天津市胸科医院心内科,300000 [2]首都医科大学附属北京安贞医院干部病房

出　　处：《中国循环杂志》2018年第9期864-868,共5页Chinese Circulation Journal

摘　　要：目的:探讨血清γ-谷氨酰转移酶(GGT)水平与老年(≥65岁)冠心病患者经皮冠状动脉介入治疗(PCI)后远期死亡率的关系。方法:选取2012-01至2013-01在北京安贞医院接受PCI的老年冠心病患者1 674例。根据血清GGT水平按三分位法将患者分为三组:GGT <20 U/L组(n=570),20~36 U/L组(n=549),> 36 U/L组(n=555)。比较三组患者3年随访期内死亡率。结果:随访期内共有146例患者死亡。GGT <20 U/L组、20~36 U/L组和> 36 U/L组的全因死亡率分别为5.3%、8.6%和12.4%(P=0.000);心原性死亡率分别为2.5%、4.2%和4.5%(P=0.146);非心原性死亡率分别为:2.8%、4.4%和7.9%(P=0.000)。校正混淆因素后,GGT 20~36 U/L组和> 36 U/L组全因死亡风险分别是<20 U/L组的1.719倍(95%CI:1.086~2.721,P=0.021)和2.508倍(95%CI:1.627~3.865,P=0.000)。GGT 20~36 U/L组和> 36 U/L组非心原性死亡风险分别是<20 U/L组的1.587倍(95%CI:0.842~2.991,P=0.153)和2.828倍(95%CI:1.588~5.035,P=0.000)。多因素Cox回归分析显示:Log GGT是老年冠心病患者PCI术后3年全因死亡(HR=4.707,95%CI:2.427~9.126,P=0.000)和非心原性死亡(HR=18.901,95%CI:7.730~46.214,P=0.000)的独立预测因素。结论:PCI术前血清GGT水平升高的老年冠心病患者,PCI术后远期全因死亡和非心原性死亡风险增高。Objectives： To investigate the association between serum gamma-glutamyl transferase（GGT） and long-term mortality in elderly patients with coronary artery disease（CAD） undergoing percutaneous coronary intervention（PCI）.Methods： The study included 1 674 elderly patients with CAD undergoing PCI in Beijing An Zhen hospital from January 2012 to January 2013. Patients were divided into three groups according to the serum GGT level（GGT20 U/L, n =570; GGT 20-36 U/L, n=549; GGT36 U/L, n=555）. Mortality during the 3-year follow-up period was compared among the three groups. Results： Death occurred in 146 patients during follow-up. All-cause mortality of the 20 U/L group, the 20-36 U/L group and the 36 U/L group was 5.3%, 8.6% and 12.4%, respectively（P=0.000）. Cardiac mortality of the 20 U/L group, the 20-36 U/L group and the 36 U/L group was 2.5%, 4.2% and 4.5%, respectively（P=0.146）. Non-cardiac mortality of the 20 U/L group, the 20-36 U/L group and the 36 U/L group was 2.8%, 4.4% and 7.9%, respectively（P=0.000）. After adjusting for confounding factors, the hazard radios（HRs） of all-cause mortality for the 20-36 U/L group and the 36 U/L group were 1.719（95%CI： 1.086-2.721, P=0.021） and 2.508（95%CI： 1.627-3.865, P=0.000）as compared to the 20 U/L group. The HRs of non-cardiac mortality for the 20-36 U/L group and the 36 U/L group were 1.587（95%CI： 0.842-2.991, P=0.153）and 2.828（95%CI： 1.588-5.035, P=0.000）as compared to the 20 U/L group. Multivariate Cox regression analysis indicated that Log GGT was independently associated with an increased risk of 3-year all-cause mortality（95%CI： 2.427-9.126, P=0.000） and non-cardiac mortality（95%CI： 7.730-46.214, P=0.000）.Conclusions： Elevated serum GGT level is associated with the increased risk of all-cause mortality and non-cardiac mortality in elderly CAD patients undergoing PCI.

关 键 词：Γ-谷氨酰转移酶 老年 经皮冠状动脉介入治疗 

分 类 号：R54[医药卫生—心血管疾病]