影响冠状动脉复杂病变患者介入治疗后临床预后的危险因素分析  

Analysis of risk factors for clinical prognosis in patients with complex coronary artery disease after percutaneous coronary intervention

作　　者：张恒亮 张培 汪靖峤 刘相勇[1] 王丹[1] 肖扬[1] 赵飞龙[1] 汪砚雨[1] ZHANG Heng-liang;ZHANG Pei;WANG Jing-qiao;LIU Xiang-yong;WANG Dan;XIAO Yang;ZHAO Fei-long;WANG Yan-yu(Department of Cardiology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Department of Gynecology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;The Medical School,Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院心内科,河南洛阳471000 [2]河南科技大学第一附属医院妇科,河南洛阳471000 [3]河南科技大学医学院,河南洛阳471000

出　　处：《实用医院临床杂志》2021年第4期8-11,共4页Practical Journal of Clinical Medicine

基　　金：洛阳市医疗卫生科技计划项目(编号1920026A、2030002A);河南省医学科技攻关计划联合共建项目(编号LHGJ20200568)。

摘　　要：目的分析影响冠状动脉复杂病变介入治疗预后的危险因素。方法连续纳入2015年1月至2017年12月于河南科技大学第一附属医院行冠脉介入治疗且术前SYNTAX积分>22分的冠心病患者640例。其中SYNTAX积分23~32分者为中危组;SYNTAX积分≥33分者为高危组。术后再次对患者进行残余SYNTAX积分(residual SYNTAX score,rSS)评估和计算。随访至2020年11月,记录患者主要心血管不良事件(MACE)情况,并分析其危险因素。结果发生MACE的患者66例(10.3%)。COX回归分析发现,SYNTAX积分、rSS、左室射血分数、N-末端脑钠肽前体(NT-proBNP)是患者发生MACE的主要独立危险因素(P<0.05)。rSS>7分的患者发生MACE的累计风险远高于≤7分者(P<0.05)。患者rSS越高,发生MACE累计风险越高。结论对于复杂冠状动脉病变行介入治疗术的患者,影响其预后的主要危险因素有术前SYNTAX积分、rSS、术前左室射血分数和NT-proBNP。Objective To analyze the risk factors affecting the prognosis of patients with complex coronary artery disease after interventional therapy.Methods From January 2015 to December 2017,patients with coronary heart disease who underwent coronary intervention in our hospital and whose preoperative SYNTAX score was greater than 22 were included.According to the results of SYNTAX score,the patients were divided into a moderate risk group in which patients’SYNTAX scores were from 23 to 32,and a high risk group in which patients’SYNTAX scores were greater than or equal to 33.The patients were followed up to November 2020 to identify and record major adverse cardiovascular events(MACE)and risk factors were analyzed.Results 66 patients(10.3%)had MACE.Cox regression analysis showed that SYNTAX score,residual SYNTAX score,left ventricular ejection fraction and NT proBNP were the main independent risk factors for MACE(P<0.05).The cumulative risk of MACE in patients with residual SYNTAX score greater than 7 was much higher than that in patients with residual SYNTAX score less than 7.The higher the residual SYNTAX score was,the higher the cumulative risk of MACE was.Conclusion For patients with complex coronary artery disease after interventional therapy,the main risk factors affecting the prognosis are preoperative SYNTAX score,postoperative residual SYNTAX,preoperative left ventricular ejection fraction,and NT proBNP.

关 键 词：冠状动脉疾病 SYNTAX积分 介入治疗 预后 

分 类 号：R541.4[医药卫生—心血管疾病]