摘要
目的探讨冠心病患者经皮冠状动脉介入(PCI)治疗后的预后特点及其影响因素。方法选取2019年1月至2020年10月在浙江省诸暨市人民医院接受PCI治疗的292例冠心病患者,依据3个月随访期间是否发生不良心血管事件,将其分为预后不良组(n=78)和预后良好组(n=214);比较两组的性别、年龄、肥胖、高血压、脑血管疾病、糖尿病、慢性肾功能不全、高脂血症、病程、心功能分级、疾病类型、病变血管数、左心室射血分数、支架安装数、吸烟史、酗酒史、cTnI、hs-CRP等资料;采用逐步logistic回归法筛选影响冠心病患者PCI治疗后预后不良的危险因素。结果292例冠心病患者行PCI治疗后的预后不良发生率为26.71%(78/292);两组间的年龄、肥胖、高血压、脑血管疾病、糖尿病、高脂血症、心功能分级、病变血管数、左心室射血分数、支架安装数、吸烟史、cTnI、hs-CRP等比较,差异有统计学意义(P<0.05);多因素logistic回归结果显示,影响冠心病患者PCI治疗后预后不良的危险因素包括高龄(OR=2.502)、高血压(OR=3.271)、心功能分级高(OR=4.773)、病变血管数多(OR=3.337)、左心室射血分数低(OR=4.389)、cTnI(OR=5.387)等,而支架安装数多(OR=0.348)则为保护性因素。结论冠心病患者PCI治疗后近期预后不良发生率仍然较高,应结合其预后不良特点及其相关影响因素,进行早预防和早治疗,降低不良心血管事件的发生率,改善患者的预后。
Objective To investigate the prognostic characteristics and influencing factors of patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 292 patients with coronary heart disease who were treated with PCI in Zhuji People′s Hospital in Zhejiang Province from January 2019 to October 2020 were selected and divided into the poor prognosis group(n=78 patients)and the good prognosis group(n=214 patients)according to the occurrence of adverse cardiovascular events during the 3-month follow-up.The data of gender,age,obesity,hypertension,cerebrovascular disease,diabetes,chronic renal insufficiency,hyperlipidemia,course of disease,cardiac function grade,disease type,number of pathological vessels,left ventricular ejection fraction,number of stent installation,smoking history,alcoholism history,cTnI,hs-CRP and so on were compared between the two groups.The stepwise logistic regression was used to screen the risk factors for poor prognosis of patients with coronary heart disease after PCI.Results The incidence of poor prognosis in 292 patients with coronary heart disease after PCI was 26.71%(78/292).Statistically significant differences were observed in age,obesity,hypertension,cerebrovascular disease,diabetes,hyperlipidemia,cardiac function grade,number of pathological vessels,left ventricular ejection fraction,number of stent installation,smoking history,cTnI and hs-CRP between the two groups(P<0.05).The multivariate logistic regression results showed that:The risk factors influencing the poor prognosis of patients with coronary heart disease after PCI included advanced age(OR=2.502),hypertension(OR=3.271),high cardiac function grading(OR=4.773),large number of pathological vessels(OR=3.337),low left ventricular ejection fraction(OR=4.389),cTnI(OR=5.387),etc.The number of stent installations(OR=0.348)was a protective factor.Conclusion The incidence of short-term adverse prognosis is still high in patients with coronary heart disease after PCI treatment.Early prevention and treatment should be carried out in combination with the characteristics of adverse prognosis and related influencing factors,so as to reduce the incidence of adverse cardiovascular events and improve the prognosis of patients.
作者
章秀梅
钱彩珍
ZHANG Xiumei;QIAN Caizhen(Department of Cardiology,Zhuji People′s Hospital in Zhejiang Province,Zhuji311800,China)
出处
《中国现代医生》
2022年第12期34-38,共5页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2021KY1165)。
关键词
冠心病
经皮冠状动脉介入
预后
影响因素
Coronary heart disease
Percutaneous coronary intervention(PCI)
Prognosis
Influencing factor
