摘要
目的探讨颈动脉粥样硬化对早发冠心病患者近期预后的预测价值.方法对132例早发冠心病患者应用B型超声检测颈动脉内膜中膜厚度和斑块情况,并进行随访,判断颈动脉粥样硬化对早发冠心病患者平均2年随访期间心脏性死亡、非致命性心肌梗死以及再发心绞痛等心血管事件的预测价值.结果 73例(55%)患者合并颈动脉粥样硬化,59例(45%)未合并颈动脉粥样硬化.颈动脉粥样硬化组年龄、患高血压比例、冠心病家族史、患糖尿病比例以及血浆低密度脂蛋白胆固醇水平明显高于非颈动脉粥样硬化组(P<0.05～0.01);两组疾病临床表型以及冠状动脉病变支数特征无差异(P>0.05).两组介入手术均获得成功.随访期间,颈动脉粥样硬化组心脏性死亡、非致命性心肌梗死及再发心绞痛事件分别为0、2和12例;非颈动脉粥样硬化组分别为0、1和3例;颈动脉粥样硬化组主要不良心血管事件明显高于非颈动脉粥样硬化组(19.4%比7.1%, P<0.05).多因素Logistic回归分析,吸烟、高低密度脂蛋白胆固醇水平和颈动脉超声阳性(OR=5.22, 95% CI为1.34～10.25, P=0.005)是早发冠心病介入术后近期主要不良心血管事件的独立预测指标.结论颈动脉粥样硬化对早发冠心病介入治疗后近期预后有预测价值,合并颈动脉粥样硬化的早发冠心病患者介入治疗术后近期主要不良心血管事件增加.
Aim To assess the predictive value of carotid atherosclerosis （CAs） on short-term outcomes in patients with premature coronary heart disease （PCHD）. Methods The present study enrolled 132 patients with PCHD for percutaneous coronary intervention （PCI）. The carotid artery IMT and plaques of the common carotid artery were measured byB-mode ultrasonography and their predictive value on mean 2-year outcomes of cardiac death, nonfatal myocardial infarction （MI） and recurrent angina for rehospitalization was evaluated. Results 73 patients （55% ） had carotid IMT≥0.8 mm and/or plaques. 72 cases with CAs and 56 without CAs were followed up for 20 ± 8 months. There were 0, 2, and 12 cases occurred cardiac death, nonfatal MI and recurrent angina for readmission respectively in PCHD patients with CAs, and it was 0, 1, and 3 in patients without CAs （19.4% vs7.1%, P〈0.05）. Mulfivariate logistic regression tevealed that CAs wss an independent predictor for majoradversecardiaeeventsinPCHDafterPCI （OR=5.22,95% CI： 1.34～10.2.5, P=0.005）. Conclusions Pafients of PCHD with concomitant CAs who underwent PCI had a greater incidences of mean 2-year major adverse cardise events than those without CAs.
出处
《中国动脉硬化杂志》
CAS
CSCD
2005年第5期610-612,共3页
Chinese Journal of Arteriosclerosis
