河北医学
河北醫學
하북의학
HEBEI MEDICINE
2014年
9期
1430-1434
,共5页
刘毅君%邓盛%熊荣生%李烨
劉毅君%鄧盛%熊榮生%李燁
류의군%산성%웅영생%리엽
冠心病%血运重建%危险因素%预后
冠心病%血運重建%危險因素%預後
관심병%혈운중건%위험인소%예후
Coronary heart disease%Revascularization%Risk factors%Prognosis
目的：探讨冠心病血运重建后影响患者预后的危险因素。方法：选取冠心病血运重建患者106例，根据患者年龄分为A组（年龄＜70岁）61例和B组（年龄≥70岁）45例。收集两组患者的临床资料、辅助检查结果、Syntax评分等资料，并进行对比。通过多因素Cox 分析探讨发生不良心脑血管事件的独立预测因素。结果：A组9．84％合并有心律失常，6．56％既往有脑血管意外病史，显著低于B组（20．00％、17．78％）（均P＜0．05）。两组患者心脏彩色超声多普勒检查各项参数的差异均没有统计学意义（均P＞0．05）。 A组的左回旋支病变比例为60．66％，右冠状动脉病变比例为36．07％，均显著低于B组（755．6％、51．11％）（均P＜0．05）；A组的病变血管数为（2．09±0．83）支，靶病变数为（1．48±0．77）支，均显著少于B组（均 P＜0．05）。 A组再次靶血管血运重建的比例为6．56％，总不良心脑血管事件的发生率为16．39％，均显著低于B组（15．56％、33．33％）（均P＜0．05）。对数秩检验提示，B组的生存率显著低于A组（ P＜0．05）。年龄、病变血管数、收缩压是血运重建后不良心脑血管事件发生的独立预测因素（ OR＝1．131、2．1581、．182，均P＜0．05）。结论：年龄、病变血管数和收缩压是发生血运重建后不良心脑血管事件的独立预测因素，且高龄患者具有更多的危险因素。
目的：探討冠心病血運重建後影響患者預後的危險因素。方法：選取冠心病血運重建患者106例，根據患者年齡分為A組（年齡＜70歲）61例和B組（年齡≥70歲）45例。收集兩組患者的臨床資料、輔助檢查結果、Syntax評分等資料，併進行對比。通過多因素Cox 分析探討髮生不良心腦血管事件的獨立預測因素。結果：A組9．84％閤併有心律失常，6．56％既往有腦血管意外病史，顯著低于B組（20．00％、17．78％）（均P＜0．05）。兩組患者心髒綵色超聲多普勒檢查各項參數的差異均沒有統計學意義（均P＞0．05）。 A組的左迴鏇支病變比例為60．66％，右冠狀動脈病變比例為36．07％，均顯著低于B組（755．6％、51．11％）（均P＜0．05）；A組的病變血管數為（2．09±0．83）支，靶病變數為（1．48±0．77）支，均顯著少于B組（均 P＜0．05）。 A組再次靶血管血運重建的比例為6．56％，總不良心腦血管事件的髮生率為16．39％，均顯著低于B組（15．56％、33．33％）（均P＜0．05）。對數秩檢驗提示，B組的生存率顯著低于A組（ P＜0．05）。年齡、病變血管數、收縮壓是血運重建後不良心腦血管事件髮生的獨立預測因素（ OR＝1．131、2．1581、．182，均P＜0．05）。結論：年齡、病變血管數和收縮壓是髮生血運重建後不良心腦血管事件的獨立預測因素，且高齡患者具有更多的危險因素。
목적：탐토관심병혈운중건후영향환자예후적위험인소。방법：선취관심병혈운중건환자106례，근거환자년령분위A조（년령＜70세）61례화B조（년령≥70세）45례。수집량조환자적림상자료、보조검사결과、Syntax평분등자료，병진행대비。통과다인소Cox 분석탐토발생불양심뇌혈관사건적독립예측인소。결과：A조9．84％합병유심률실상，6．56％기왕유뇌혈관의외병사，현저저우B조（20．00％、17．78％）（균P＜0．05）。량조환자심장채색초성다보륵검사각항삼수적차이균몰유통계학의의（균P＞0．05）。 A조적좌회선지병변비례위60．66％，우관상동맥병변비례위36．07％，균현저저우B조（755．6％、51．11％）（균P＜0．05）；A조적병변혈관수위（2．09±0．83）지，파병변수위（1．48±0．77）지，균현저소우B조（균 P＜0．05）。 A조재차파혈관혈운중건적비례위6．56％，총불양심뇌혈관사건적발생솔위16．39％，균현저저우B조（15．56％、33．33％）（균P＜0．05）。대수질검험제시，B조적생존솔현저저우A조（ P＜0．05）。년령、병변혈관수、수축압시혈운중건후불양심뇌혈관사건발생적독립예측인소（ OR＝1．131、2．1581、．182，균P＜0．05）。결론：년령、병변혈관수화수축압시발생혈운중건후불양심뇌혈관사건적독립예측인소，차고령환자구유경다적위험인소。
Objective:To investigate the risk factors of patients with coronary heart disease ( CHD) af-ter revascularization and the relationship with prognosis .Method: One hundred and six patients with CHD after revascularization were selected .According to the age , the patients were divided into group A ( age<70 years with 61 cases) and group B (aged≥70 years with45 cases).The clinical data, auxiliary examination results, scores of Syntax of the two groups were collected and compared .The independent risk factors of ad-verse cardiovascular events were analyzed by Cox analysis .Rseult:In group A, 9.84%patients with arrhyth-mia, 6.56%patients with cerebral vascular accident history , which were significantly lower than those of group B (20 .00%,17.78%) ( all P<0.05) .The differences between the two groups of patients with cardiac color doppler ultrasound parameters were not statistically significant ( P>0.05) .In group A, patients with left circumflex artery disease accounted for 60.66%and 36.07%with right coronary artery disease .Which were significantly lower than those in group B (75.56%,51.11%) (all P<0.05).The numbers of diseased vessels in group A were (2.09±08.3) and the target diseased vessels were (1.48±0.77).Which were significantly less than the group B (P<0.05).Patients in group A with target vessel revascularization accounted for 6. 56%and the total adverse cardiovascular event rate was 16.39%.Which were significantly lower than those in group B(15.56%,33 .33%) ( all P<0.05).Log-rank test indicated that the survival rate of patients in group B was significantly lower than that of group A (P<0.05).Age, the numbers of diseased vessels and systolic blood pressure were independent risk factors of adverse cardiovascular events ( OR=1.131, 2.158, 1.182, P<0.05).Conclusion: Age, the numbers of diseased vessels and systolic blood pressure are inde-pendent predictors of adverse cardiovascular events and the elderly patients have more risk factors .
