摘要
目的探讨经皮冠状动脉介入术(PCI)后患者的生存情况及其影响因素。方法DESIRE注册研究(Drug-Eluting Stent Impact on Revascularization)为单中心回顾性注册研究,记录我院接受血运重建治疗患者的临床、血清学、药物治疗和冠状动脉病变特征情况。主要终点定义为全因死亡。结果DESIRE研究共入选3763例患者,仅进行PCI治疗的2144例患者入选,平均随访(811.3±360.7)d,随访率84.0%。共发生死亡58例(3.2%,58/1801),其中院内死亡12例(0.6%),随访死亡46例(2.6%,46/1789)。年龄、血肌酐和住院时应用他汀类药物与总病死率相关(年龄:HR 1.058,95% CI 1.012～1.105,P=0.012;血肌酐:HR 1.652,95% CI 1.059～2.578,P=0.027;住院时应用他汀类药物:HR 0.380,95% CI 0.179～0.807,P=0.012)。另外,左心室射血分数升高,病死率有降低趋势,但差异无统计学意义(HR 0.964,95% CI 0.929～1.001,P=0.054)。结论行PCI患者远期预后佳,病死率较低,年龄、血肌酐和住院时应用他汀类药物可分别独立预测PCI术后死亡的发生。
Objective To elucidate the survival and influence factors in patients undergoing percutaneous coronary intervention（ PCI ）. Methods DESIRE register study （ Drug-Eluting Stent Impact on Revascularization ） was a single-center retrospective study,and enrolled patients received revascularization therapy. Clinical,laboratory, medicine therapy,coronary artery lesion and revascularization features were recorded. Primary end-point was defined as all-cause mortality. Results Among 3763 patients enrolled in the study,2144 （ 57% ） received PCI, except of the patients accepted percutaneous coronary intervention and coronary artery bypass graft simultaneously. Mean duration of follow-up was （ 811.3 ± 360.7 ） days. During follow-up,46 patients （ 2.6% ） died, 12 died in the hospital （0.6%）. Multivariable logistic regression analysis showed that age （HR 1. 058,95% CI 1. 012-2. 61. 105, P = 0. 012 ）, creatine level （ HR 1. 652,95 % CI 1. 059-2. 578, P = 0. 027 ）, statins prescription during the hospitaliza- tion （HR 0. 380,95% CI 0. 179-0. 807 ,P = 0.012 ） was associated with all-cause mortality. Greater left ventricular ejection fraction had a trend of decreased mortality（ HR 0. 964,95% CI 0. 929-1. 001 ,P = 0. 054 ） , but the difference was not significant. Conclusion The occurrence of mortality is low in the patients receiving PCI. Age,ereatine,the utilization of statins during the hospitalization is independent predictor of mortality after PCI.
出处
《中国综合临床》
北大核心
2007年第7期577-579,共3页
Clinical Medicine of China
基金
国家重点基础研究发展计划(973计划)课题(2003CB517103)
关键词
冠心病
经皮冠状动脉介入术
生存率
Coronary heart disease
Pereutaneous coronary intervention
Survival rate
