急性冠脉综合征患者PCI术后治疗效果的影响因素分析  

Factors influencing the curative effect in patients with acute coronary syndrome after percutaneous coronary intervention

作　　者：李雪梅 韩建伦[1] 刘亮 LI Xue-mei;HAN Jian-lun;LIU Liang(Internal Medicine-Cardiovascular Department,the First Hospital of Yulin City,Yulin 719000,Shaanxi,CHINA)

机构地区：[1]榆林市第一医院心内科,陕西榆林719000

出　　处：《海南医学》2021年第7期839-842,共4页Hainan Medical Journal

摘　　要：目的研究急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后影响治疗效果的因素。方法回顾性分析2015年1月至2019年1月于榆林市第一医院心内科行PCI治疗的798例ACS患者的临床资料,根据术后6个月治疗结局将患者分为疗效好组639例和疗效差组159例,利用单因素分析和多因素Logistic回归分析法筛选ACS患者PCI术后治疗效果的影响因素,并利用匹兹堡睡眠质量指数量表(PSQI)将患者分为睡眠障碍组295例和睡眠无障碍组503例,比较两组患者的心脏彩超指数、术后支架内再狭窄(ISR)、主要不良心脑血管事件(MACCE)等预后情况。结果单因素分析结果显示,疗效好组患者中有高脂血症史、糖尿病史、高血压史及睡眠障碍者所占百分比明显低于疗效差组,差异均有统计学意义(P<0.05);多因素分析结果显示,高脂血症史、糖尿病史、高血压史以及睡眠障碍均是影响ACS患者PCI治疗效果的独立危险因素(P<0.05);睡眠无障碍组患者PCI术后心脏彩超的左心室射血分数(LVEF)、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)分别为(51.20±4.22)%、(50.89±2.56)mm、(38.68±2.34)mm,明显优于睡眠障碍组的(47.96±3.67)%、(55.10±5.77)mm、(44.52±2.85)mm,且ISR、MACCE总发生率分别为35.93%、18.98%,明显高于睡眠无障碍组的27.83%、9.34%,差异均有统计学意义(P<0.05)。结论睡眠障碍与ACS患者PCI疗效及预后密切相关,提高睡眠质量有利于心功能恢复和预防MACCE发生。Objective To explore the factors influencing the curative effect in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods The clinical data of 798 patients with ACS treated by PCI in the Department of Cardiology,the First Hospital of Yulin City from January 2015 to January 2019 were retrospectively analyzed.According to the treatment outcomes at 6 months after operation,the patients were divided into good curative effect group(639 cases)and poor curative effect group(159 cases).Univariate analysis and multivariate logistic regression analysis were performed to screen factors influencing the therapeutic effects in patients with ACS after PCI.According to the Pittsburgh Sleep Quality Index(PSQI),the patients were divided into sleep disorder group(295 cases)and non-sleep disorder group(503 cases).The cardiac color Doppler ultrasound indexes,postoperative in-stent restenosis(ISR),and major adverse cardiovascular and cerebrovascular events(MACCE)were compared between the two groups of patients.Results Univariate analysis showed that the percentages of patients with hyperlipidemia history,diabetes history,hypertension history,and sleep disorders in the good curative effect group were significantly lower than those in the poor curative effect group(P<0.05).Multivariate analysis showed that hyperlipidemia history,diabetes history,hypertension history,and sleep disorders were the independent risk factors influencing the curative effect of PCI in patients with ACS(P<0.05).After PCI,the cardiac color Doppler ultrasound indexes such as left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)of the non-sleep disorder group were(51.20±4.22)%,(50.89±2.56)mm,and(38.68±2.34)mm,significantly better than(47.96±3.67)%,(55.10±5.77)mm,and(44.52±2.85)mm of the sleep disorder group.The incidences of ISR and MACCE in the sleep disorder group were 35.93% and 18.98%,significantly higher than 27.83% and 9.34% in the n

关 键 词：睡眠障碍 急性冠脉综合征 经皮冠状动脉介入手术 疗效 心功能 支架内再狭窄 主要不良心脑血管事件 

分 类 号：R543.3[医药卫生—心血管疾病]