冠状动脉慢性完全闭塞的临床预测因素分析

Clinical predictors of coronary chronic total occlusion

目的研究冠状动脉（冠脉）慢性完全闭塞（CTO）的临床预测因素。方法对比分析203例CTO患者（CTO组）和173例非CTO患者（非CTO组）急性冠脉综合征的临床特征。结果CTO组较非CTO组急性冠脉综合征病程长（P〈0.01）、急性心肌梗死病程长（P〈0.01）、年龄大（P〈0.01）；CTO组急性冠脉综合征反复发生的比例高于非CTO组（80.8％比59.5％，P〈0.01）。Logistic回归分析显示CTO临床预测因素为急性冠脉综合征病程≥12个月（OR=4.313，95％CI为1.020-18.142，P〈0.05）。结论CTO与急性冠脉综合征的病程及反复发作有关，急性冠脉综合征病程≥12个月是一个独立预测CTO的临床因素。

Objective To study the clinical predictors of coronary chronic total occlusion （CTO）. Methods The clinical characteristics of 203 patients with CTO （CTO group）and 173 patients without CTO （none CTO group） were analyzed. Results In CTO group the courses of acute coronary syndromes and acute myocardial infarct were 47 months （ median ） and 30 months （ median ） respec- tively, which were significantly longer than those in none CTO group（P 〈 0.01 ）. The recurrent rate of frequent acute coronary syndromes in CTO group was 80. 8%. It was significantly higher than that （ 59.5% ） in none CTO group（ P 〈 0.01 ）. On multiple logistic regression analysis, the course of acute coronary syndromes（≥12 months）（OR= 4.313,95% CI： 1.020 to 18.142, P 〈 0.05）was the inde-pendent predictor of CTO. Conclusioas CTO is associated with the history and frequency of acute cor-onary syndromes. The longer the comes and the more the frequency of acute coronary syndromes, the higher the rate of CTO. The course of acute coronary syndromes （≥12 months） is the independent pre-dictor of CTO.