摘要
目的经皮冠状动脉介入术(percutaneous coronary intervention,PCI)是临床治疗冠心病的主要方法,但部分冠心病患者在PCI术后易发生不良心脏事件,导致预后不良。本研究探讨老年冠心病患者PCI术后发生不良心脏事件的危险因素。方法选择2017-02-01-2019-06-31郑州人民医院接受PCI术的老年冠心病患者为研究对象,其中术后发生不良心脏事件的20例患者为病例组,未发生不良心脏事件100例患者为对照组。分析老年冠心病患者PCI术后发生不良心脏事件的危险因素。结果单因素分析结果显示,病例组≥70岁患者所占比例为75.00%,高于对照组的43.00%,χ2=6.834,P=0.009;合并高血压患者所占比例为65.00%,高于对照组的34.00%,χ2=6.722,P=0.010;合并糖尿病患者所占比例为35.00%,高于对照组的13.00%,χ2=5.808,P=0.016;合并高脂血症患者所占比例为90.00%,高于对照组的61.00%,χ2=6.232,P=0.013;有吸烟史者所占比例为50.00%,高于对照组的23.00%,χ2=6.094,P=0.014;血尿酸≥360μmol/L所占比例为40.00%,高于对照组的17.00%,χ2=5.346,P=0.021;超敏C反应蛋白≥0.5mg/L所占比例为35.00%,高于对照组的14.00%,χ2=5.091,P=0.024。多因素Logistics回归分析结果显示,年龄≥70岁(OR=3.977,95%CI为1.341~11.790,P=0.013)、合并高血压(OR=3.605,95%CI为1.316~9.875,P=0.013)、合并糖尿病(OR=3.604,95%CI为1.214~10.697,P=0.021)、合并高脂血症(OR=5.754,95%CI为1.265~26.181,P=0.024)、吸烟史(OR=3.348,95%CI为1.241~9.033,P=0.017)、血尿酸≥360μmol/L(OR=3.255,95%CI为1.155~9.169,P=0.026)及超敏C反应蛋白≥0.5mg/L(OR=3.308,95%CI为1.125~9.726,P=0.030)与老年冠心病患者PCI术后不良心脏事件有关联。结论老年冠心病患者PCI术后发生不良心脏事件的危险因素较多,临床需根据其危险因素采取针对性防治措施。
OBJECTIVE percutaneous coronary intervention(PCI)is the main means of clinical treatment of coronary heart disease,but some patients with coronary heart disease are prone to adverse cardiac events after PCI,leading to poor prognosis.To investigate the risk factors for adverse cardiac events after PCI in elderly patients with coronary heart disease.METHODS Elderly patients with coronary heart disease who underwent PCI in our hospital from February 1,2017 to June 31,2019 were the subjects of the study.According to whether there were adverse cardiac events after operation,20 cases(occurrence)and 100 cases(not occurring)were divided into observation group.To analyze the risk factors of adverse cardiac events in elderly patients with coronary heart disease after PCI.RESULTS In univariate analysis,75.00%of patients in the case group≥70 years old were significantly higher than 43.00%in the control group(χ2=6.834,P=0.009).65.00%of the cases with hypertension were significantly higher than 34.00%of the controls(χ2=6.722,P=0.010).35.00%of the patients with diabetes mellitus were significantly higher than 13.00%of the controls(χ2=5.808,P=0.016).90.00%of the patients with hyperlipidemia were significantly higher than 61.00%of the controls(χ2=6.232,P=0.013).The proportion of patients with smoking history in the case group was 50.00%,which was significantly higher than that in the control group(χ2=6.094,P=0.014).The proportion of serum uric acid≥360μmol/L in the case group was 40.00%,which was significantly higher than that in the control group(χ2=5.346,P=0.021).In the case group,the proportion of high sensitive C-reactive protein≥0.5 mg/L was 35.00%,which was significantly higher than that of the control group(χ2=5.091,P=0.024).By multivariate logistic regression analysis,age≥70 years old(OR=3.977,95%CI:1.341-11.790,P=0.013),hypertension(OR=3.605,95%CI:1.316-9.875,P=0.013),diabetes(OR=3.604,95%CI:1.214-10.697,P=0.021),hyperlipidemia(OR=5.754,95%CI:1.265-26.181,P=0.024),smoking history(OR=3.348,95%CI:1.241-9.033,P=0.017),hematuric acid≥360μmol/L(OR=3.255,95%CI:1.155-9.169,P=0.026),hypersensitive C-reactive protein≥0.5 mg/L(OR=3.308,95%CI:1.125-9.726,P=0.030)were related to adverse cardiac events after PCI in eldly patients with coronary heart disease.CONCLUSION Elderly patients with coronary heart disease have many risk factors for adverse cardiac events after PCI,and clinical prevention and treatment measures should be taken according to their risk factors.
作者
丁亚楠
韩文杰
王浩坤
DINGYa-nan;HAN Wen-jie;WANG Hao-kun(Department of Cardiology,Zhengzhou People's Hospital,Zhengzhou450000,P.R.China)
出处
《社区医学杂志》
2020年第7期486-489,共4页
Journal Of Community Medicine
关键词
冠心病
经皮冠状动脉介入术
不良心脏事件
危险因素
coronary heart disease
percutaneous coronary intervention
adverse cardiac events
risk factors
