急性冠状动脉综合征合并糖尿病患者经PCI治疗术后6个月内再入院相关危险因素分析  

Analysis of Risk Factors Associated with Hospital Readmission Within 6 Months After PCI Treatment for Patients with Aacute Coronary Syndrome and Diabetes

作　　者：尹育华[1] 张金龙 郝璐璐 刘景华[1] 崔燕玲[1] 张莎莎 李新华[1] 谷寅煜 王艳春[1] YIN Yuhua(Chengde Central Hospital, Hebei Chengde 067000, China)

机构地区：[1]河北省承德市中心医院,河北承德067000 [2]承德医学院研究生院,河北承德067000

出　　处：《河北医学》2022年第6期992-997,共6页Hebei Medicine

基　　金：河北省承德市科技计划项目,(编号:201903A017)。

摘　　要：目的:探讨急性冠状动脉综合征合并糖尿病患者经皮冠状动脉介入治疗术后6个月内再入院相关危险因素的分析,为改善患者的生活质量和预后提供可靠依据。方法:选取本院2019年5月至2021年11月经我院诊断ACS合并糖尿病患者并行经皮冠状动脉介入治疗的300例患者,根据患者术后6个月是否发生非计划性的再入院,将其分为对照组(未再入院216例)和研究组(再入院84例),回顾性分析患者的年龄、既往疾病史、既往用药史、实验室检查结果以及血管病变等临床资料,分析再入院的原因以及危险因素。结果:研究组84例患者,再入院原因:胸痛27例(占32.14%),胸闷21例(占25.00%),急性心肌梗死为9例(占10.71%),肺部感染9例(占10.71%),不稳定性心绞痛为6例(7.14%),心衰6例(7.14%),其他6例(7.14%);再入院时间:≤30d再入院者为18例(21.43%),31~60d再入院者为30例(35.71%),≤180d再入院者为36例(42.86%);本文中300例研究对象,其中研究组为两次或者多次入院治疗的84例患者,再入院率为28.00%;单因素分析可见,两组患者的年龄、心肌梗死、心绞痛、术前空腹血糖、吸烟史、低密度脂蛋白胆固醇、心电图ST段改变、Gensini评分、阿司匹林均有明显统计学差异(P<0.05);经Logistic多因素回归分析,年龄(OR=1.480,95%cl:1.077~2.033)、心肌梗死(OR=4.91,95%cl:1.52~15.98)、心绞痛(OR=1.679,95%cl:1.023~2.738)、吸烟史(OR=1.001,95%cl:1.000~1.002)、LDL(OR=2.327,95%Cl:2.003~3.018)、心电图ST段改变(OR=3.81,95%cl:1.94~4.470)、Gensini评分(OR=1.580,95%Cl:1.166~2.140)均为ACS患者PCI术后6个月再入院独立危险因素。结论:年龄、心肌梗死、心绞痛、吸烟史、LDL、心电图ST段改变评分、Gensini评分为ACS合并糖尿病患者经皮冠状动脉介入治疗术后6个月内再入院的独立危险因素,可以积极的采用二级预防措施进行早期干预,有望减少再入院的发生,从而改善患者的生活质量。Objective:To analysize the risk factors associated with re-admission within 6 months after percutaneous coronary intervention for patients with acute coronary syndrome and diabetes,and to provide a reliable basis for improving the quality of life and prognosis of patients.Method:A total of 300 patients were selected,who were diagnosed with ACS and diabetes in our hospital from May 2019 to November 2021 and undergone percutaneous coronary intervention.According to whether the patients had unplanned readmissions 6 months after surgery,they were divided into a control group(216 cases,no re-admission to hospital)and a study group(84 cases,re-admitted).The patient’s age,disease history,medication history,laboratory test results,vascular disease and other clinical data were analyzed retrospectively.Reasons for admission and risk factors were analyzed.Results:Reasons for re-admission of 84 patients in the study group:27 cases of chest pain(32.14%),21 cases of chest tightness(25.00%),9 cases of acute myocardial infarction(10.71%),9 cases of pulmonary infection(10.71%)%),6 cases of unstable angina(7.14%),6 cases of heart failure(7.14%),and 6 cases of other reasons(7.14%);re-admission time:18(21.43%)readmissions in≤30 days,30(35.71%)readmissions in 31-60 days and 36(42.86%)readmissions in≤180 days;the study involved 300 subjects,of which the 84 cases in the study group were treated twice or more(readmission rate,28.00%);univariate analysis showed obvious statistical difference on items of age,myocardial infarction,angina pectoris,preoperative blood glucose,smoking history,low-density lipoprotein cholesterol,ECG ST segment changes,Gensini score,and aspirin(P<0.05);Logistic multivariate regression analysis verified that age(OR=1.480,95%cl:1.077-2.033),myocardial infarction(OR=4.91,95%cl:1.52-15.98),angina(OR=1.679,95%cl:1.023-2.738),smoking history(OR=1.001,95%cl:1.000-1.002),LDL(OR=2.327,95%Cl:2.003-3.018),ECG ST segment changes(OR=3.81,95%Cl:1.94-4.470),Gensini score(OR=1.580,95%Cl:1.166-2.140)were all independent ri

关 键 词：急性冠脉综合征 糖尿病 经皮冠状动脉介入治疗术 非计划再入院 危险因素 

分 类 号：R54[医药卫生—心血管疾病]