非心脏病病人开腹手术后发生MACE的影响因素  

INFLUENCING FACTORS FOR MAJOR ADVERSE CARDIAC EVENTS AFTER LAPAROTOMY IN PATIENTS WITHOUT HEART DISEASES

作　　者：阮凤启 战玉竹[3] 彭洪皓 吴昌亮[1] 王培戈[1] RUAN Fengqi;ZHAN Yuzhu;PENG Honghao;WU Changliang;WANG Peige(Emergency Surgery,Affiliated Hospital of Qingdao University,Qingdao 266071,China)

机构地区：[1]青岛大学附属医院急诊普外科,山东青岛266071 [2]临沂市人民医院急诊外科 [3]青岛大学人体机能学实验室

出　　处：《青岛大学学报（医学版）》2020年第5期540-543,共4页Journal of Qingdao University(Medical Sciences)

基　　金：国家自然科学基金面上项目(81270449)。

摘　　要：目的探讨非心脏病病人开腹手术后主要不良心血管事件(MACE)的影响因素。方法回顾性分析非心脏病开腹手术病人317例的临床资料,按照手术后是否发生MACE分为MACE组和非MACE组,应用单因素及多因素Logistic回归方法分析两组MACE发生的影响因素。结果317例开腹手术病人手术后发生MACE 17例,发生率为5.36%。与非MACE组比较,MACE组年龄显著增高(t=-3.176,P<0.01),术前高密度脂蛋白(HDL-C)、清蛋白(ALB)、血红蛋白(HB)、体质量指数(BMI)、淋巴细胞计数(Lymph^#)、高密度脂蛋白与胆固醇比值(HDL-C/TC)等显著减少,差异均有统计学意义(t=1.979~4.964,P<0.05)。多因素Logistic分析显示,年龄≥68岁(OR=3.880,P<0.05)是非心脏病病人开腹手术后近期MACE发生的独立危险因素,HDL-C/TC≥0.7813(OR=0.159,P<0.05)、HB≥77.5 g/L(OR=0.188,P<0.05)则是非心脏病病人开腹手术后MACE发生的保护因素。结论非心脏病病人开腹手术后MACE的发生受年龄、HDL-C/TC、HB等因素独立影响,术前控制HDL-C/TC、HB水平可减少其MACE的发生。Objective To investigate the influencing factors for major adverse cardiac events(MACE)after laparotomy in patients without heart diseases.Methods A retrospective analysis was performed for the clinical data of 317 patients without heart diseases who underwent laparotomy,and according to the presence or absence of MACE after surgery,the patients were divided into MACE group and non-MACE group.Univariate and multivariate Logistic regression analyses were used to analyze the influencing factors for MACE.Results Of all 317 patients,17 experienced MACE,with an incidence rate of 5.36%.Compared with the non-MACE group,the MACE group had a significantly older age(t=-3.176,P<0.01)and significant reductions in preoperative high-density lipoprotein cholesterol,albumin,hemoglobin,body mass index,lymphocyte count,and high-density lipoprotein cholesterol-to-total cholesterol(HDL-C/TC)ratio(t=1.979-4.964,P<0.05).The multivariate logistic regression analysis showed that age≥68 years(OR=3.880,P<0.05)was an independent risk factor for MACE shortly after laparotomy in the patients without heart diseases,while HDL-C/TC ratio≥0.7813(OR=0.159,P<0.05)and hemoglobin≥77.5 g/L(OR=0.188,P<0.05)were protective factors against MACE after laparotomy.Conclusion The occurrence of MACE in patients without heart diseases after laparotomy is independently affected by the factors such as age,HDL-C/TC ratio,and hemoglobin,and control of HDL-C/TC ratio and hemoglobin before surgery can reduce the incidence rate of MACE in such patients.

关 键 词：开腹手术 心血管事件 影响因素 

分 类 号：R459.7[医药卫生—急诊医学]