中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2014年
4期
290-294
,共5页
张波%董馨%张妍%黄榕翀%尹达%郑振国%刘玉果%朱皓%周旭晨
張波%董馨%張妍%黃榕翀%尹達%鄭振國%劉玉果%硃皓%週旭晨
장파%동형%장연%황용충%윤체%정진국%류옥과%주호%주욱신
冠状动脉疾病%血管成形术,经腔,经皮冠状动脉%胆固醇,LDL
冠狀動脈疾病%血管成形術,經腔,經皮冠狀動脈%膽固醇,LDL
관상동맥질병%혈관성형술,경강,경피관상동맥%담고순,LDL
Coronary disease%Angioplasty,transluminal,percutaneous coronary%Cholesterol,LDL
目的 探讨急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后低密度脂蛋白胆固醇(LDL-C)的达标率及其影响因素.方法 回顾性分析2011年3月至2012年3月在大连医科大学附属第一医院心内科行PCI的ACS患者832例.以2011年欧洲心脏病学会和欧洲动脉粥样硬化学会血脂异常管理指南(欧洲指南)、2007年中国成人血脂异常防治指南及2012年中国经皮冠状动脉介入治疗指南(中国指南)为依据,评价ACS患者PCI术后1、9个月的LDL-C达标率,并采用多因素logistic回归分析其影响因素.结果 根据欧洲指南,术后1、9个月LDL-C的达标率分别为25.2％ (210/832)和22.2％ (185/832);根据中国指南,术后1、9个月LDL-C的达标率分别为46.5％ (387/832)和42.3％ (352/832).按照中国指南标准进行多因素logistic回归分析显示,女性(OR=0.650,95％ CI:0.442 ～0.956),年龄≥60岁(OR=0.628,95％ CI:0.464 ～0.850)、高血压(OR=0.737,95％ CI:0.547～0.994)、既往心肌梗死史(OR=0.696,95％ CI:0.511～0.948)、既往PCI史(OR=0.575,95％ CI:0.339 ～0.974)及术前基线LDL-C水平(OR =0.155,95％ CI:0.096 ～0.252)是影响PCI术后1个月LDL-C达标率的独立影响因素;既往心肌梗死史(OR=0.706,95％ CI:0.521～0.958)、既往PCI史(OR=0.565,95％ CI:0.334 ～0.957)及术前基线LDL-C水平(OR=0.176,95％ CI:0.110～0.282)是影响PCI术后9个月LDL-C达标率的独立影响因素.结论 ACS患者PCI术后LDL-C达标率低,需要加强女性、老年、高血压、既往有心肌梗死、PCI史及基线LDL-C水平较高的ACS患者PCI术后的调脂治疗.
目的 探討急性冠狀動脈綜閤徵(ACS)患者經皮冠狀動脈介入治療(PCI)術後低密度脂蛋白膽固醇(LDL-C)的達標率及其影響因素.方法 迴顧性分析2011年3月至2012年3月在大連醫科大學附屬第一醫院心內科行PCI的ACS患者832例.以2011年歐洲心髒病學會和歐洲動脈粥樣硬化學會血脂異常管理指南(歐洲指南)、2007年中國成人血脂異常防治指南及2012年中國經皮冠狀動脈介入治療指南(中國指南)為依據,評價ACS患者PCI術後1、9箇月的LDL-C達標率,併採用多因素logistic迴歸分析其影響因素.結果 根據歐洲指南,術後1、9箇月LDL-C的達標率分彆為25.2％ (210/832)和22.2％ (185/832);根據中國指南,術後1、9箇月LDL-C的達標率分彆為46.5％ (387/832)和42.3％ (352/832).按照中國指南標準進行多因素logistic迴歸分析顯示,女性(OR=0.650,95％ CI:0.442 ～0.956),年齡≥60歲(OR=0.628,95％ CI:0.464 ～0.850)、高血壓(OR=0.737,95％ CI:0.547～0.994)、既往心肌梗死史(OR=0.696,95％ CI:0.511～0.948)、既往PCI史(OR=0.575,95％ CI:0.339 ～0.974)及術前基線LDL-C水平(OR =0.155,95％ CI:0.096 ～0.252)是影響PCI術後1箇月LDL-C達標率的獨立影響因素;既往心肌梗死史(OR=0.706,95％ CI:0.521～0.958)、既往PCI史(OR=0.565,95％ CI:0.334 ～0.957)及術前基線LDL-C水平(OR=0.176,95％ CI:0.110～0.282)是影響PCI術後9箇月LDL-C達標率的獨立影響因素.結論 ACS患者PCI術後LDL-C達標率低,需要加彊女性、老年、高血壓、既往有心肌梗死、PCI史及基線LDL-C水平較高的ACS患者PCI術後的調脂治療.
목적 탐토급성관상동맥종합정(ACS)환자경피관상동맥개입치료(PCI)술후저밀도지단백담고순(LDL-C)적체표솔급기영향인소.방법 회고성분석2011년3월지2012년3월재대련의과대학부속제일의원심내과행PCI적ACS환자832례.이2011년구주심장병학회화구주동맥죽양경화학회혈지이상관리지남(구주지남)、2007년중국성인혈지이상방치지남급2012년중국경피관상동맥개입치료지남(중국지남)위의거,평개ACS환자PCI술후1、9개월적LDL-C체표솔,병채용다인소logistic회귀분석기영향인소.결과 근거구주지남,술후1、9개월LDL-C적체표솔분별위25.2％ (210/832)화22.2％ (185/832);근거중국지남,술후1、9개월LDL-C적체표솔분별위46.5％ (387/832)화42.3％ (352/832).안조중국지남표준진행다인소logistic회귀분석현시,녀성(OR=0.650,95％ CI:0.442 ～0.956),년령≥60세(OR=0.628,95％ CI:0.464 ～0.850)、고혈압(OR=0.737,95％ CI:0.547～0.994)、기왕심기경사사(OR=0.696,95％ CI:0.511～0.948)、기왕PCI사(OR=0.575,95％ CI:0.339 ～0.974)급술전기선LDL-C수평(OR =0.155,95％ CI:0.096 ～0.252)시영향PCI술후1개월LDL-C체표솔적독립영향인소;기왕심기경사사(OR=0.706,95％ CI:0.521～0.958)、기왕PCI사(OR=0.565,95％ CI:0.334 ～0.957)급술전기선LDL-C수평(OR=0.176,95％ CI:0.110～0.282)시영향PCI술후9개월LDL-C체표솔적독립영향인소.결론 ACS환자PCI술후LDL-C체표솔저,수요가강녀성、노년、고혈압、기왕유심기경사、PCI사급기선LDL-C수평교고적ACS환자PCI술후적조지치료.
Objective To observe the low-density lipoprotein cholesterol (LDL-C) target goal attainment rate and related factors in patients with acute coronary syndrome (ACS) after pcrcutaneous coronary intervention (PCI).Methods From March 2011 to March 2012,a total of 832 ACS patients were retrospectively evaluated in the Cardiology Department of the First Affiliated Hospital of Dalian Medical University.The target goal attainment rate after PCI was defined as the percentage of patients reaching LDL-C goals recommended by The European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) guidelines for the management of dyslipidemias (European guidelines) and Chinese guidelines on prevention and treatment of dyslipidemias in adults and Chinese guidelines on percutaneous coronary artery intervention treatment (Chinese guidelines).Multivariate logistic regression analysis was used to analyze the related factors.Results According to the European guidelines,the overall LDL-C goal attainment rates at 1 month and 9 months after PCI were 25.2％ (210/832) and 22.2％ (186/832),respectively.According to the Chinese guidelines,the overall LDL-C goal attainment rates at 1 month and 9 months after PCI were 46.5％ (387/832) and 42.3％ (352/832),respectively.In accordance with the Chinese guidelines,the multivariate logistic regression analysis showed that gender (females/males,OR =0.650,95 ％ CI:0.442-0.956),age (≥ 60 years/＜ 60 years,OR =0.628,95 ％ CI:0.464-0.850),hypertension (OR =0.737,95％ CI:0.547-0.994),prior myocardial infarction history (OR =0.696,95％ CI:0.511-0.948),prior PCI history (OR =0.575,95 ％ CI:0.339-0.974) and baseline LDL-C levels (OR =0.155,95％ CI:0.096-0.252) were independent risk factors that affected LDL-C goal attainment at 1 month post PCI.Moreover,the following parameters were the independent risk factors for LDL-C goal attainment at 9 months after PCI:prior myocardial infarction history (OR =0.706,95％ CI:0.521-0.958),prior PCI history (OR =0.565,95％ CI:0.334-0.957) and baseline LDL-C levels (OR =0.176,95％ CI:0.110-0.282).Conclusions Currently,the LDL-C control rate is low in patients with ACS after PCI.The cholesterol lowering therapy should be individually strengthened for patients after PCI,especially in female patients,patients with aged ≥ 60 years old,hypertension,prior myocardial infarction history,prior PCI history and higher baseline LDL-C level.
