急性冠脉综合征患者不良心血管预后的影响因素  

Influencing Factors of Adverse Cardiovascular Prognosis in Patients with Acute Coronary Syndrome

作　　者：杨春华[1] 牛少辉[2] 王珂[1] YANG Chunhua;NIU Shaohui;WANG Ke(Department of Cardiology,Zhoukou Central Hospital,Zhoukou 466000,China;Department of Cardiology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]周口市中心医院心内科,河南周口466000 [2]郑州大学第二附属医院心内科,河南郑州450000

出　　处：《河南医学研究》2024年第2期296-299,共4页Henan Medical Research

摘　　要：目的探讨急性冠脉综合征(ACS)患者预后发生主要不良心血管事件(MACE)的影响因素。方法从医院2019年2月至2022年2月收治的急性冠脉综合征患者中选取200例,随访1 a,观察MACE的发生情况,并根据随访结果进行分组,收集并对比两组一般资料[性别、年龄、体重指数(BMI)、吸烟史、饮酒史、基础合并症(高血压、糖尿病)、心血管病家族史]、临床指标(冠脉病变支数、植入支架数)、心功能指标[左室射血分数(LVEF)]、实验室指标[肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)]。绘制受试者工作特征(ROC)曲线分析冠脉病变支数、LVEF、CK-MB、cTnT预测ACS患者预后发生MACE的价值。采用多因素logistic回归分析明确ACS患者预后发生MACE的危险因素。结果随访1 a后,MACE组40例(20.00%),未发生MACE组160例(80.00%)。两组性别、年龄、BMI、吸烟史、饮酒史、高血压、糖尿病、心血管病家族史、植入支架数对比,差异无统计学意义(P>0.05),发生MACE组冠脉病变支数1支占比高于未发生MACE组(P<0.05),LVEF低于未发生MACE组(P<0.05),CK-MB、cTnI高于对照组(P<0.05)。经ROC分析证实LVEF、CK-MB、cTnI均可预测ACS患者预后发生MACE,曲线下面积分别为0.763、0.960、0.914(P<0.05)。多因素logistic回归分析显示冠脉病变支数>1支、LVEF≤53.35%、CK-MB≥173.81 U·L^(-1)、cTnI≥0.62μg·L^(-1)均为ACS患者预后发生MACE的危险因素(P<0.05)。结论冠脉病变支数>1支、LVEF≤53.35%、CK-MB≥173.81 U·L^(-1)、cTnI≥0.62μg·L^(-1)均为ACS患者预后发生MACE的危险因素。Objective To investigate the influencing factors of major adverse cardiovascular events(MACE)in the prognosis of patients with acute coronary syndrome(ACS).Methods A total of 200 patients with acute coronary syndrome admitted to the hospital from February 2019 to February 2022 were followed up for 1 year to observe the occurrence of MACE,and were grouped according to the follow-up results.General data[gender,age,body mass index(BMI),smoking history,drinking history,basic complications(hypertension,diabetes),family history of cardiovascular disease],clinical indicators(number of coronary artery lesions,number of stents implanted),cardiac function indicators[left ventricular ejection fraction(LVEF)],laboratory indicators[creatine kinase isoenzyme(CK-MB),troponin T(cTnT)].Draw receiver operating characteristic(ROC)curves to analyze the value of predicting MACE in ACS patients based on the number of coronary artery lesions,LVEF,CK-MB,and cTnT.Using multiple logistic regression analysis to identify the risk factors for MACE in ACS patients.Results After 1 year of follow-up,there were 40 cases(20.00%)in the MACE group and 160 cases(80.00%)in the non MACE group.There was no significant difference in gender,age,BMI,smoking history,drinking history,hypertension,diabetes,family history of cardiovascular disease,and the number of stents implanted between the two groups(P>0.05).The number of coronary artery lesions in the group with MACE was higher than that in the group without MACE(P<0.05),LVEF was lower than that in the group without MACE(P<0.05),and CK-MB and cTnI were higher than those in the control group(P<0.05).ROC analysis confirmed that LVEF,CK-MB,and cTnI can all predict the occurrence of MACE in ACS patients,with areas under the curves of 0.763,0.960,and 0.914,respectively(P<0.05).Multivariate logistic regression analysis showed that the number of coronary artery lesions was>1,LVEF≤53.35%,CK-MB≥173.81 U·L^(-1),and cTnI≥0.62μg·L^(-1) was risk factors for the occurrence of MACE in ACS patients(P<0.05).Conc

关 键 词：急性冠脉综合征 不良心血管事件 预后 影响因素 

分 类 号：R543[医药卫生—心血管疾病]