经皮冠状动脉介入治疗术后不同性别早发冠心病患者的临床特点及远期预后的影响因素分析  

Analysis of Clinical Characteristics and Factors Influencing the Long-Term Prognosis of Patients with Premature Coronary Artery Disease by Gender After Percutaneous Coronary Intervention

作　　者：霍明艳[1] 张娜[1] 刘环亚[1] 周青云[1] 王珠秀[1] HUO Mingyan;ZHANG Na;LIU Yahuan(The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China)

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《河北医学》2022年第3期412-417,共6页Hebei Medicine

基　　金：河北省医学研究课题计划,(编号:20211603)。

摘　　要：目的:探讨经皮冠状动脉介入治疗(PCI)术后不同性别早发冠心病(PCAD)患者的临床特点以及远期预后的影响因素分析,为患者的治疗提供指导性。方法:选取承德医学院附属医院于2018年2月至2020年2月经我院诊断为冠心病并行经皮冠状动脉介入治疗术的150例患者,将患者按照性别比分为男性组和女性组,收集并记录所有患者的临床资料、介入治疗资料以及随访记录,将其分析早发冠心病(PCAD)患者的临床特点,并进一步探讨远期预后的影响因素。结果:男性组患者中发病年龄小(P<0.01),吸烟比例高(P<0.05),BMI指数高,ST段抬高型心肌梗死比例(P<0.05)、肾小球滤过率(P<0.01)、左心室舒张末期内径(P<0.01)、高血脂(P<0.05)比例均高,而患高血压(P<0.05)、糖尿病(P<0.05)发病比例低,既往卒中史发病比例高(P<0.05),经统计学分析有统计学意义;而两组男女比例中,左心室射血分数和GRACE评分中,无统计学差异(P>0.05);两组患者不良事件发生率(包括MACCE、死亡、心肌梗死、再次血运重建、卒中)无明显统计学差异(P>0.05),但女性组出血率明显高于男性组,出血差异主要表现在BARC1~2级间的区分,经统计学分析有统计学差异(P<0.05)。结论:经皮冠状动脉介入治疗术后不同性别早发冠心病患者的临床特点各不相同,针对于不同性别的患者应遵循个体化的治疗方式,鼓励患者养成良好的生活方式,减轻患者的代谢异常,从而有望减少早发冠心病的发生率,其次女性和心肌梗死是PCI术后出血的影响因素,识别这些术后因素,可为患者后期的治疗提供一定的指导性。Objective:To investigate the clinical characteristics of patients with premature coronary artery disease(PCAD)by gender after percutaneous coronary intervention(PCI),to analyze factors influencing long-term prognosis,and to provide guidance for the treatment of patients.Methods:Totally 150 patients admitted to the Affiliated Hospital of Chengde Medical University from February 2018 to February 2020 who were diagnosed with coronary heart disease and underwent percutaneous coronary intervention were selected as research subjects and divided into male and female groups.The clinical data,interventional treatment data and follow-up of all patients were recorded,the clinical characteristics of premature coronary artery disease(PCAD)were analyzed,and the influencing factors of long-term prognosis were further explored.Results:In the male group,the age of onset was younger(P<0.01),the proportion of smoking was higher(P<0.05),the BMI index was higher,and the proportion of ST-segment elevation myocardial infarction(P<0.05),the glomerular filtration rate(P<0.01),left ventricular end-diastolic diameter(P<0.01),and hyperlipidemia(P<0.05)were all high,while the incidence of hypertension(P<0.05)and diabetes(P<0.05)was low,and the incidence of previous stroke was high.(P<0.05),which was statistically significant after statistical analysis.However,there was no statistical difference in the left ventricular ejection fraction and GRACE score between the two groups(P>0.05);the incidence of adverse events between the two groups(including MACCE,death,myocardial infarction,revascularization,and stroke)showed no significant difference(P>0.05),but the bleeding rate in the female group was significantly higher than that in the male group.Bleeding differences are mainly manifested in the distinction between BARC levels 1-2.Statistical analysis showed statistical difference(P<0.05).Conclusion:The clinical characteristics of patients with premature coronary artery disease of different genders after percutaneous coronary intervention are diff

关 键 词：早发冠心病 介入治疗 临床特点 远期预后 

分 类 号：R54[医药卫生—心血管疾病]