急性冠脉综合征患者介入术后近期主要心脏不良事件发生的多项预测因素分析  

Multiple Predictive Factors of Recent Major Adverse Cardiac Events after Intervention in Patients with Acute Coronary Syndrome

作　　者：姚靖[1] 靳祺 李思雪 徐冬梅[1] YAO Jing;JIN Qi;LI Sixue;XU Dongmei(Department of Cardiology,Beijing Haidian Hospital(Peking University Third Hospital Haidian District),Beijing 100080,China)

机构地区：[1]北京市海淀医院(北京大学第三医院海淀院区)心内科,北京市100080

出　　处：《中国分子心脏病学杂志》2022年第6期5040-5044,共5页Molecular Cardiology of China

基　　金：北京市科技计划项目(D19240307)。

摘　　要：目的 探究经介入治疗后的急性冠脉综合征(acute coronary syndrome,ACS)患者术后近期主要心脏不良事件发生的多项预测因素。方法 回顾性选取2019年3月至2020年3月接受经皮冠状动脉介入治疗的142例ACS患者,介入术后随访1个月,统计患者主要心脏不良事件的发生情况。分析患者介入术后近期主要心脏不良事件发生的相关影响因素。结果 (1)介入术后近期发生主要心脏不良事件的患者为30例(21.13%)。(2)吸烟、体重指数(body mass index,BMI)、糖尿病病史、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、白细胞计数为影响ACS患者介入术后近期主要心脏不良事件发生的单因素(P <0.05)。(3)经非条件多因素logistic回归模型分析发现,吸烟(有)(OR=1.770,95%CI:1.152~2.719)、糖尿病病史(有)(OR=1.853,95%CI:1.038~3.311)、TC(异常升高)(OR=1.861,95%CI:1.211~2.858)、LDL-C(异常升高)(OR=1.809,95%CI:1.017~3.220)、白细胞计数(异常升高)(OR=1.800,95%CI:1.058~3.062)为影响ACS患者介入术后近期主要心脏不良事件发生的独立危险因素(P <0.05)。结论 吸烟、糖尿病病史、TC、LDL-C、白细胞计数为ACS患者介入术后近期主要心脏不良事件发生的有力预测因素,临床应密切关注上述因素的变化,以减少心脏不良事件的发生。Objective To explore multiple predictors of recent major adverse cardiac events in patients with acute coronary syndrome(ACS) after interventional therapy.Methods A total of 142 patients with ACS who received percutaneous coronary intervention in our hospital from March 2019 to March 2020 were retrospectively selected.The patients were followed up for 1 month after intervention,and the incidence of major adverse cardiac events was counted.The related influencing factors of recent major adverse cardiac events in patients after interventional surgery were analyzed.Results(1) There were 30 patients(21.13%) with recent major adverse cardiac events after intervention.(2) Smoking,body mass index(BMI),history of diabetes,total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C) and white blood cell count were the single factors influencing the occurrence of recent major cardiac adverse events in patients with ACS after intervention(P <0.05).(3) According to the analysis of unconditional multivariate logistic regression model,smoking(OR =1.770,95%CI:1.152-2.719),history of diabetes(OR =1.853,95%CI:1.038-3.311),abnormally elevated TC(OR =1.861,95%CI:1.211-2.858),abnormally elevated LDL-C(OR =1.809,95%CI:1.017-3.220),and abnormally elevated white blood cell count(OR =1.800,95%CI:1.058-3.062) were the independent risk factors affecting the interventional surgery in patients with ACS for recent major adverse cardiac events(P <0.05).Conclusions Smoking,history of diabetes,TC,LDL-C,and white blood cell count are strong predictors of recent major adverse cardiac events in patients with ACS after intervention,clinical attention should be paid to the changes of these factors to reduce adverse cardiac events happened.

关 键 词：预测因素 心脏不良事件 介入术后 急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]