不同年龄妇科肿瘤患者围手术期心血管不良事件发生的对比分析  

Comparative analysis of perioperative cardiovascular adverse events in patients with gynecological tumors of different age groups

作　　者：蔡有芹 张豪锋[1] 张军[1] CAI Youqin;ZHANG Haofeng;ZHANG Jun(Department of Gynaecology and Obstetrics,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所妇产科,100029

出　　处：《心肺血管病杂志》2021年第7期716-720,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨不同年龄组妇科肿瘤患者围手术期心血管不良事件(MACE)风险,并分析MACE相关的影响因素。方法:回顾性队列研究。选取2015年1月至2018年12月,我院收治的402例行非急诊妇科恶性肿瘤手术患者,根据年龄分为老年组(60-80岁,179例)和非老年组(23-59岁,223例)。主要观察指标为围术期MACE事件,并分析影响发生MACE的相关因素。结果:共纳入402例患者,平均年龄(56.8±11.2)岁。两组患者的年龄、BMI、衰弱、FGB和左心室舒张末期容积等,差异均有统计学意义(均为P<0.05)。平均随访(23.3±6.0)d,25例(6.2%)MACE事件。老年组和非老年组的心力衰竭或肺水肿(HR=1.618)、新发的急性心肌梗死(HR=1.604)、心室颤动或心脏骤停(HR=1.963)、完全性房室传导阻滞(HR=2.112)和MACE事件(HR=1.876)发生率均相似,差异无统计学意义。多因素COX风险比例回归分析结果显示,年龄≥60岁(HR=2.864)、糖尿病(HR=2.277)、陈旧心肌梗死(HR=1.897)、衰弱(HR=2.372)、高BNP(HR=2.811)和高RCRI评分(HR=4.583)是发生MACE事件的独立危险因素,而ACEI/ARB(HR=0.714)是其保护危险因素。结论:老年非急诊妇科恶性肿瘤手术患者围术期MACE事件风险不高于非老年患者,年龄、糖尿病、陈旧心肌梗死、衰弱、脑利钠肽和RCRI评分是其的危险因素。Objective:To explore the risk of perioperative adverse cardiovascular events(MACE)in gynecological cancer patients undergoing surgery,and analyze MACE-related influencing factors.Methods:This study was a retrospective cohort study.Patients who underwent non-emergency gynecological malignant tumor surgery in our hospital from January 2015 to December 2018 were enrolled,and were divided into elderly group(≥60-80 years,179 cases)and non-elderly group(30-59 years,223 cases).The main outcome measures were MACE events during the perioperative period and the related factors for MACE were analyzed.Results:A total of 402 patients were enrolled,with an average age of(56.8±11.2)years.The differences in age,body mass index,frailty,fasting blood glucose,and left ventricular end-diastolic volume between the two groups were statistically significant(all P<0.05).The average follow-up time was(23.3±6.0)d,and there were 25 MACE events(6.8%).The incidences of heart failure or pulmonary edema(HR=1.618),new acute myocardial infarction(HR=1.604),ventricular fibrillation or cardiac arrest(HR=1.963),complete atrioventricular block(HR=2.112)and MACE events(HR=1.876)were similar between groups.Multivariate Cox risk ratio regression analysis showed that age≥60 years(HR=2.864),diabetes(HR=2.277),previous myocardial infarction(HR=1.897),frailty(HR=2.372),high brain natriuretic peptide level(HR=2.811)and high RCRI score(HR=4.583)were independent risk factors for MACE events,while ACEI/ARB(HR=0.714)was its protective risk factor.Conclusions:The risk of perioperative MACE events in elderly patients is not higher than that in non-elderly patients.Age,diabetes,old myocardial infarction,weakness,brain natriuretic peptide and RCRI score are independent risk factors.

关 键 词：妇科肿瘤 老年 围术期 心血管不良事件 危险因素 

分 类 号：R54[医药卫生—心血管疾病]