高龄冠心病患者多支血管病变PCI术后发生MACE的危险因素研究  

Risk factors of major adverse cardiovascular events in elderly patients with coronary artery disease after percutaneous coronary intervention

作　　者：李景隆[1] 罗灿伟 黄连娇 吕明芳[1] 赖文娇 黄颖 唐国芳[1] 许启春 乌汉东[2] LI Jing-long;LUO Can-wei;HUANG Lian-jiao;LV Ming-fang;LAI Wen-jiao;HUANG Ying;TANG Guo-fang;XU Qi-chun;WU Han-dong(Department of Cardiovascular Medicine,Guangzhou Eighth People's Hospital,Guangzhou 510060,Guangdong,CHINA;Department of Cardiovascular Medicine,Guangdong Provincial People's Hospital,Guangzhou 510080,Guangdong,CHINA)

机构地区：[1]广州市第八人民医院心血管内科,广东广州510060 [2]广东省人民医院心血管内科,广东广州510080

出　　处：《海南医学》2020年第21期2733-2735,共3页Hainan Medical Journal

摘　　要：目的探究高龄冠心病患者多支血管病变经皮冠状动脉介入治疗(PCI)术后主要心血管不良事件(MACE)的危险因素,为临床工作提供参考依据。方法回顾性分析2018年1月至2019年6月在广州市第八人民医院和广东省人民医院治疗的80例高龄(年龄≥75岁)冠心病多支血管病变患者的临床资料,其中26例发生MACE,54例未发生MACE。所有患者均接受PCI术治疗,对发生MACE的影响因素进行单因素分析,MACE发生的危险因素采用多因素Logistic回归分析。结果经单因素分析结果显示,影响MACE发生的主要因素中,年龄>80岁、吸烟、血脂代谢异常、糖尿病、高血压、饮酒、肥胖、慢性阻塞性肺疾病、重症肺炎、颈动脉粥样硬化斑均与MACE的发生有关(P<0.05);经多因素Logistic回归分析结果显示,年龄>80岁、吸烟、血脂代谢异常、糖尿病、高血压、饮酒、肥胖、慢性阻塞性肺疾病、重症肺炎、颈动脉粥样硬化斑块均是患者PCI术后发生MACE的独立危险因素(P<0.05)。结论高龄冠心病患者多支血管病变PCI术后MACE的发生由多种危险因素共同作用引起,临床工作中针对危险因素制定相应的预防措施是防止发生MACE的关键,也是提高患者生活质量,减少患者死亡率的重要措施。Objective To explore the risk factors of major adverse cardiovascular events(MACE)in elderly patients with coronary artery disease after percutaneous coronary intervention(PCI),and to provide reference for clinical prevention.Methods The clinical data of 80 elderly patients(age≥75 years)with multivessel disease of coronary heart disease treated at the Guangzhou Eighth People's Hospital and Guangdong Provincial People's Hospital from January 2018 to June 2019 were retrospectively analyzed,including 26 patients with MACE and 54 patients without MACE.All patients were treated with PCI,and the influencing factors of MACE were analyzed by single factor.The risk factors of MACE were analyzed by multivariate logistic regression analysis.Results Univariate analysis showed that among the main factors affecting the occurrence of MACE,age>80 years old,smoking,abnormal lipid metabolism,diabetes,hypertension,alcohol consumption,obesity,chronic obstructive pulmonary disease,severe pneumonia,carotid atherosclerotic plaque are related to the occurrence of MACE(P<0.05).Multivariate logistic regression analysis showed that age>80 years old,smoking,abnormal blood lipid metabolism,diabetes,hypertension,drinking,obesity,chronic obstructive pulmonary disease,severe pneumonia,carotid atherosclerotic plaques were all independent risk factors for MACE after PCI(P<0.05).Conclusion The occurrence of MACE in elderly patients with multivessel disease after PCI is caused by the combined effect of multiple risk factors.In clinical work,the development of corresponding preventive measures for risk factors is an important measure to prevent MACE from occurring,and also to improve the quality of life and reduce the mortality of patients.

关 键 词：冠心病 高龄 多支血管病变 经皮冠状动脉介入治疗 主要心血管不良事件 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]