冠状动脉钙化积分预测介入治疗多支病变冠心病患者远期预后的价值  

The value of coronary artery calcification score in predicting long-term prognosis of CAD patients with multi-vessel lesions undergoing interventional therapy

作　　者：张伟[1] 隋赟[1] Zhang Wei;Sui Yan(Department of Internal Medicine,Jinan Second People's Hospital,Jinan 250001,China)

机构地区：[1]济南市第二人民医院内科,250001

出　　处：《国际医药卫生导报》2020年第11期1561-1564,共4页International Medicine and Health Guidance News

摘　　要：目的探讨冠状动脉钙化积分(coronary artery calcification score,CCS)作为预测接受介入治疗多支病变冠心病(coronary artery disease,CAD)患者远期预后指标的临床意义。方法连续招募2013年1月至2016年9月于本院心内科接受冠状动脉介入治疗的多支病变CAD患者155例,收集患者临床资料、实验室及影像学指标及CCS,所有患者出院后均常规随访28个月,记录患者随访期间出现心血管不良事件(MACE)情况及无事件生存时间,根据患者预后分为两组,即MACE组(n=39)及非MACE组(n=116),比较两组患者临床指标差异及CCS与MACE之间的相关性。结果(1)与非MACE组相比,MACE组CCS、Cr、年龄及NT-proBNP更高(均P<0.05);(2)多因素logistic回归分析提示年龄及CCS与预后不良密切相关,其优势比(OR)(95%CI)分别为4.97(3.79-6.51)及1.50(1.29-1.73);(3)Kaplan-Meier分析发现CCS≥median组患者无MACE事件生存时间显著低于CCS<median组(P<0.05);(4)COX比例风险回归分析发现,CCS及NT-proBNP是影响接受介入治疗多支病变CAD患者远期预后不良的影响因素,其危险比(HR)(95%CI)分别为1.07(0.79-1.46)及1.01(1.00-1.03)(均P<0.05)。结论CCS是潜在的评估接受介入治疗冠心病患者远期预后的临床指标。Objective To investigate the clinical significance of coronary artery calcification score(CCS)as a predictor for long-term prognosis in CAD patients with multi-vessel lesions undergoing interventional therapy.Methods A total of 155 CAD patients with multi-vessel lesions who underwent coronary intervention in our department between January 2013 and September 2016 were enrolled.Clinical data,laboratory and imaging parameters,and CCS were collected.All patients were followed-up for 28 months after discharged to collect major adverse cardiovascular events(MACE)and event-free survival time.According to the prognosis,the patients were divided into MACE group(n=39)and non-MACE group(n=116).The clinical indicators were compared between the two groups,and the correlation between CCS and MACE was analyzed.Results(1)Compared with non-MACE group,the level of CCS,Cr,age,and NT-proBNP were higher in MACE group(all P<0.05).(2)Multivariate logistic regression analysis indicated that age and CCS were closely related to MACE,their odds ratio(OR)(95%CI)were 4.97(3.79-6.51)and 1.50(1.29-1.73),respectively.(3)Kaplan-Meier analysis found that MACE-free survival time of patients with CCS≥median was significantly lower than that of CCS<median group(P<0.05).(4)COX proportional hazard regression analysis found that CCS and NT-proBNP served as negative factors in long-term prognosis of CAD patients with multi-vessel lesions undergoing interventional therapy,their HR(95%CI)were 1.07(0.79-1.46)and 1.01(1.00-1.03),respectively(all P<0.05).Conclusion CCS was a potential clinical indicator for evaluating the long-term prognosis of CAD patients with multi-vessel lesions undergoing interventional therapy.

关 键 词：冠状动脉钙化积分 介入治疗 多支病变 冠心病 预后 

分 类 号：R541.4[医药卫生—心血管疾病]