青年急性冠脉综合征患者PCI术后发生MACE的影响因素及其与Gensini积分的关系  

Influencing Factors of MACE After PCI in Young Patients with Acute Coronary Syndrome and Its Relationship with Gensini Score

作　　者：韩龙 叶智帅 李守祯 徐谭 HAN Long;YE Zhishuai;LI Shouzhen;XU Tan(Department of Cardiovascular Medicine,Xinyang Central Hospital,Xinyang 464000,China;Department of Cardiology,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China)

机构地区：[1]信阳市中心医院心血管内科,河南信阳464000 [2]首都医科大学附属北京友谊医院心内科,北京100050

出　　处：《河南医学研究》2024年第20期3721-3724,共4页Henan Medical Research

摘　　要：目的 分析青年急性冠脉综合征(ACS)患者经皮冠脉介入术(PCI)后发生主要心血管不良事件(MACE)的影响因素及其与Gensini积分的关系。方法 选取信阳市中心医院2021年6月至2022年6月收治的198例青年ACS患者作为研究对象,均接受PCI,术后随访1 a, 6例失访,共192例完成随访,并记录MACE发生情况。根据是否发生MACE分为MACE组(35例)、非MACE组(157例),收集一般资料及Gensini积分并进行对比,分析影响疾病转归的因素、Gensini积分与疾病转归相关性。结果 两组高血压、支架直径、植入支架个数、心肌肌钙蛋白I(cTnI)、肥胖、肌酸激酶同工酶MB(CK-MB)、同型半胱氨酸(HCY)、Gensini积分比较,差异有统计学意义(P<0.05);多因素分析显示,植入支架个数>1个、cTnI≥8.76μg·L^(-1)、CK-MB≥25.93 U·L^(-1)、HCY≥12.55μmol·L^(-1)、Gensini积分≥13.85分为青年ACS患者PCI后发生MACE的危险因素,支架直径≥3.07 mm为青年ACS患者PCI后发生MACE的保护因素(P<0.05);植入支架个数、cTnI、CK-MB、Gensini积分与疾病转归呈正相关,支架直径与疾病转归呈负相关(P<0.05)。结论 青年ACS患者PCI术后发生MACE受多个因素影响,且植入支架个数、支架直径、cTnI、CK-MB、HCY、Gensini积分与疾病转归存在直接关联性,可为临床制定早期防治措施起到指导作用。Objective To analyze the influencing factors of major adverse cardiovascular events(MACE)in young patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI)and their relationship with Gensini score.Methods A total of 198 young patients with ACS admitted to Xinyang Central Hospital from June 2021 to June 2022 were selected as the study objects.All of them underwent PCI and were followed up for 1 year after surgery.Six cases were lost to follow up,and a total of 192 cases completed the follow-up,and MACE were recorded.According to whether MACE occurred,the patients were divided into MACE group(35 cases)and non-MACE group(157 cases).General data and Gensini scores of all subjects were collected and compared to analyze the influencing factors and the correlation between Gensini scores and disease outcomes.Results There were statistical differences in hypertension,stent diameter,number of implanted stents,cardiac troponin I(cTnI),obesity,creatine kinase isoenzyme MB(CK-MB),homocysteine(HCY)and Gensini scores in two group(P<0.05).Multivariate analysis showed that the number of implanted stents>1,cTnI≥8.76μg·L^(-1),CK-MB≥25.93 U·L^(-1),HCY≥12.55μmol·L^(-1),and Gensini score≥13.85 were the risk factors for MACE in young ACS patients after PCI,stent diameter≥3.07 mm was a protective factor for MACE in young ACS patients after PCI(P<0.05).The number of implanted stents,cTnI,CK-MB and Gensini scores were positively correlated with the disease outcome,while the stent diameter was negatively correlated with the disease outcome(P<0.05).Conclusion The risk of MACE in young ACS patients after PCI is affected by multiple factors,and the number of implanted stents,stent diameter,cTnI,CK-MB,HCY and Gensini scores are directly correlated with disease outcome,which can provide guidance for clinical development of early prevention and treatment measures.

关 键 词：急性冠脉综合征 冠脉介入术 GENSINI积分 疾病转归 

分 类 号：R543.3[医药卫生—心血管疾病]