老年急性冠脉综合征患者经皮冠状动脉介入治疗术后发生不良心脏事件的危险因素分析  

Risk factors of major adverse cardiac events after percutaneous coronary intervention in elderly patients with acute coronary syndrome

作　　者：谢楠[1] 李剑[1] 许璨[1] Xie Nan;Li Jian;Xu Can(Department of Cardiology,First Affiliated Hospital of Nanhua University,Hengyang 421001,China)

机构地区：[1]南华大学附属第一医院心内科

出　　处：《中国循证心血管医学杂志》2019年第9期1121-1124,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨并分析采用经皮冠状动脉介入治疗(PCI)老年急性冠状动脉(冠脉)综合征(ACS)患者术后主要不良心脏事件(MACE)的危险因素。方法选取2013年1月至2016年1月于南华大学附属第一医院就诊的老年ACS患者187例作为研究对象,采用回顾性分析方法,依据是否发生MACE,将其分为发生MACE的A组和未发生MACE的B组,对促发术后MACE发生的危险因素进行分析研究。结果术后1年和术后2年内患者的MACE发生率分别为12.30%和15.51%。2年内老年ACS患者术后的MACE的发生率高达27.81%。单因素分析结果显示,与B组相比,A组患者在年龄、高血压、高血脂、糖尿病、辅助用药情况、心功能分级、吸烟、饮酒、冠状动脉(冠脉)病变支数、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及白细胞计数方面存在统计学差异(P<0.05)。两组在性别、独居、首次PCI、体质指数(BMI)及肌酸激酶同工酶不存在统计学差异(P>0.05)。在多因素Logistic回归分析中,结果显示,年龄、高血压、高血脂、糖尿病、辅助用药情况、冠脉病变支数、心功能分级、吸烟、饮酒、TC、LDL-C、HDL-C及白细胞计数是导致老年ACS患者行PCI后MACE发生的重要因素。结论老年ACS患者PCI后,MACE发生率较高,通过改善不良生活习惯,并辅助药物治疗,有效改善患者预后。Objective To discuss and analyze the risk factors of major adverse cardiac events(MACE)after percutaneous coronary intervention(PCI)in elderly patients with acute coronary syndrome(ACS).Methods ACS patients(n=187)were chosen from the First Affiliated Hospital of Nanhua University from Jan.2013 to Jan.2016.All patients were divided,according to invasion of MACE,into MACE group(group A)and non-MACE group(group B).The risk factors of MACE after PCI were analyzed and studied.Results The incidence of MACE was 12.30%after PCI for 1 y and 15.51%within 2 y after PCI,and the total incidence of MACE was 27.81%within 2 y after PCI in elderly ACS patients.The results of single-factor analysis showed that there were statistical differences in age,hypertension,hyperlipidemia,diabetes,adjuvant medication,heart function grading,smoking,drinking,lesion vessels of coronary artery,total cholesterol(TC),high-density lipoprotein-cholesterol(HDL-C),low-density lipoprotein-cholesterol(LDL-C)and white blood cell count(WBC)between group A and group B(P<0.05).There were no differences in sex,living alone,first-time PCI,body mass index(BMI)and creatine kinase-MB isoenzyme(CK-MB)between 2 groups(P>0.05).The results of Logistic regression analysis showed that age,hypertension,hyperlipidemia,diabetes,adjuvant medication,lesion vessels of coronary artery,heart function grading,smoking,drinking,TC,LDL-C,HDL-C and WBC were important risk factors of MACE after PCI in ACS patients.Conclusion The incidence of MACE was higher after PCI in elderly ACS patients.The prognosis of the patients will be improved through changing unhealthy living habits and taking adjuvant medicines.

关 键 词：老年 急性冠脉综合征 经皮冠状动脉介入 主要不良心脏事件 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]