急性冠状动脉综合征患者强化他汀治疗对临床预后的影响  

Effect of intensive statin therapy on clinical outcomes in patients with acute coronary syndromes

作　　者：贺红艳 孙菁 孟庆义 HE Hong-Yan;SUN Jing;MENG Qing-Yi(Department of Health Management,Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第二医学中心健康医学科,北京100853

出　　处：《中华老年多器官疾病杂志》2022年第5期341-344,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的探讨急性冠状动脉综合征(ACS)患者强化他汀治疗对临床预后的影响。方法入选2013年4月至2014年4月于中国人民解放军总医院第一医学中心确诊的ACS患者546例。根据他汀类药物初始治疗剂量分为普通治疗组(n=431)和强化治疗组(n=115)。比较2组患者的一般资料及临床预后情况。应用SPSS 17.0软件对数据进行统计分析。根据数据类型,组间比较采用t检验或χ^(2)检验。采用Cox回归模型分析影响患者预后的危险因素。结果最长随访时间为5年,中位随访时间为4.3年。随访期间共有13例(2.38%)患者死亡,其中因心脏原因死亡12例(2.20%),因肺部感染死亡1例(0.18%)。强化治疗组心绞痛[6.96%(8/115)和28.54%(123/431)]及主要不良心血管事件(MACE)[18.26%(21/115)和32.71%(141/431)]发生率低于普通治疗组,差异有统计学意义(均P<0.05)。Cox多元回归分析显示,糖尿病病史(OR=1.533,95%CI 1.131~2.077;P=0.006)及年龄(OR=1.003,95%CI 1.001~1.031;P=0.037)是ACS患者发生MACE的显著危险预测因子。结论ACS合并糖尿病患者发生MACE的风险高,ACS患者接受强化他汀类药物治疗可降低MACE发生率。Objective To explore the effect of intensive statin therapy on clinical outcomes in patients with acute coronary syndrome(ACS).Methods A total of 546 ACS patients diagnosed at the First Medical Center of Chinese PLA General Hospital between April 2013 and April 2014 were enrolled in this study.According to their initial statin dose,they were divided into common treatment group(n=431)and intensive treatment group(n=115).The general data and clinical outcomes were compared between the 2 groups.SPSS 17.0 was applied for statistical analysis.Depending on the data types,student′s t test or Chi-square test was employed for intergroup comparison.Cox regression model was used to analyze the risk factors affecting the prognosis of patients.Results The longest follow-up period was 5 years,and the median time was 4.3 years.There were 13(2.38%)patients who died during follow-up,including 12(2.20%)due to cardiac causes and 1(0.18%)to pulmonary infection.The incidences of angina[6.96%(8/115)vs 28.54%(123/431)]and major adverse cardiovascular events(MACE)[18.26%(21/115)vs 32.71%(141/431)]was significantly lower in the intensive treatment group than the common treatment group(all P<0.05).Cox multiple regression analysis showed that history of diabetes(OR=1.533,95%CI 1.131-2.077;P=0.006)and age(OR=1.003,95%CI 1.001-1.031;P=0.037)were significant risk predictors for MACE in ACS patients.Conclusion ACS patients complicated with diabetes mellitus are at high risk of MACE,and intensive statin therapy can reduce the incidence.

关 键 词：急性冠状动脉综合征 糖尿病 主要不良心血管事件 随访 

分 类 号：R541.4[医药卫生—心血管疾病]