冠心病患者围手术期血栓前状态与心脏不良事件的相关性研究  

Study on the correlation between prethrombotic state and adverse cardiac events in patients with coronary heart disease during the perioperative period

作　　者：郭睿[1] 杨洋[1] 杨文彬[1] GUO Rui;YANG Yang;YANG Wen-bin

机构地区：[1]广东省广州市海珠区广东省第二人民医院心血管内三科,广州市510500

出　　处：《护理实践与研究》2020年第22期46-48,共3页Nursing Practice and Research

摘　　要：目的探讨冠心病患者围手术期血栓前状态(PTS)与心脏不良事件的相关性。方法选择2018年1月至2019年1月收治的64例老年冠心病患者为研究对象,在患者手术当天(T1)、术后1(T2)、2(T3)、3 d(T4)测定PTS相关指标血浆D-二聚体(D-D)、血栓前体蛋白(TpP)及P-选择素(CD62-P)水平并对患者进行西雅图心绞痛量表(SAQ)及急性冠脉综合征(ACS)反应指数量表评价,分析各项血清指标与心脏不良事件的相关性及各量表评分对于心脏不良事件的预见性。结果患者在4个不同时间点进行PTS分子标记物及相关量表评分比较,术后患者标志物水平、量表评分均有升高(P<0.05),说明手术会导致血栓前状态加重,标志物水平、量表评分均为影响患者出现心脏不良事件的危险因素。心肌缺血与心律失常、心梗、ACS量表呈正相关(P<0.05),与SAQ量表呈负相关(P<0.05);心律失常与心肌缺血心梗、ACS量表呈正相关(P<0.05),与SAQ量表呈负相关(P<0.05);心梗与心肌缺血与心律失常、ACS量表呈正相关(P<0.05),SAQ量表呈负相关(P<0.05)。结论血栓前状态分析标志物水平增高的冠心病手术患者在围术期出现心脏不良事件的概率会高于各指标及量表评分稳定患者,提示各标志物水平及量表评分能够作为提示心脏不良事件的指示性指标,在评估及预测心脏不良事件上有积极的临床价值,患者血栓前状态与不良事件存在密切关联性。Objective To explore the correlation between prethrombotic state(PTS)and adverse cardiac events in patients with coronary heart disease during the perioperative period.Methods To select 64 cases of elderly patients with coronary heart disease who were treated from January 2018 to January 2019 as the study objects,and PTS-related indicators,such as plasma D-dimer(D-D),thrombus precursor protein(TpP)and P-selectin(CD62-P)levels were measured on the day of operation(T1),1 d(T2),2 d(T3),and 3 d(T4)after the operation,and the patients were evaluated with Seattle angina questionnaiire(SAQ)and acute coronary syndrome(ACS)response index scales to analyze the correlation between various serum indexes and cardiac adverse events and the predictability of each scale score for cardiac adverse events.Results The patients were compared with PTS molecular markers and related scale scores at 4 different time points.The levels of markers and scale scores of the patients increased after operation(P<0.05),indicating that the operation would lead to aggravation of the prethrombotic state,and the level of markers and scale scores were all risk factors that affected patients with adverse cardiac events.Myocardial ischemia was positively correlated with arrhythmia,myocardial infarction,ACS scale score(P<0.05),and negatively correlated with SAQ scale score(P<0.05).Arrhythmia was positively correlated with myocardial ischemia,myocardial infarction,ACS scale score(P<0.05),and negatively correlated with SAQ scale score(P<0.05).Myocardial infarction was positively correlated with myocardial ischemia,arrhythmia,ACS scale score(P<0.05),and negatively correlated with SAQ scale score(P<0.05).Conclusion Patients undergoing coronary heart disease operation with increased levels of prethrombotic status analysis markers were more likely to have cardiac adverse events during the perioperative period than patients with stable indicators and scale scores,suggesting that the levels of markers and scale scores can be used as a reminder of the heart indic

关 键 词：冠心病 围手术期 血栓前状态 心脏不良事件 相关性 

分 类 号：R473.5[医药卫生—护理学]