动脉僵硬度对介入治疗患者的危险分层及预后评价

The value of arterial stiffness in risk stratification and outcome evaluation in patients receiving percutaneous coronary intervention

目的探讨动脉僵硬度对PCI患者的危险分层和预后评价。方法选择冠心病并行PCI的患者316例,均进行颈-股脉搏波传导速度(cfPWV)检测评价动脉僵硬度。根据cfPWV水平将患者分为3组,Ⅰ组67例(cfPWV0-10.0 m/s),Ⅱ组98例(cfPWV)0.1-13.0 m/s),Ⅲ组151例(cfPWV>13.0 m/s)。记录患者临床特征、术后并发症和随访主要心血管事件(MACE)发生率,并行相关分析。结果与Ⅰ组和Ⅱ组比较,Ⅲ组年龄偏大,糖尿病、心肌梗死和高血压所占比例多,C型病变和3支病变多见(p<0.05)。术后并发症发生率、远期非致死性心肌梗死和血运重建发生率显著增加(P<0.05)。cfPWV与MACE发生呈正相关(OP=1.98,95%CI:1.039-3.770)。结论 cfPwV与冠状动脉病变的严重程度及PCI后远期MACE发生率增加密切相关。

Objective To investigate the value of arterial stiffness in risk stratification and outcome evaluation in patients receiving PCI. Methods 316 consecutive patients who received PCI were studied. Carotid-femoral pulse wave velocity（cfPWV） was measured to evaluate large artery stiffness. According to cfPWV they were divided into 3 groups：group Ⅰ （cfPWV 0-10.0 m/s,67 patients） ,group Ⅱ （cfPWV 10. 1-13.0 m/s,98 patients）, group Ⅲ （cfPWV〉13. 0 m/s, 151 patients）. The clinical characteristics and main adverse cardiac events（MACE） during follow-up period were analyzed. Results The percentages of old patients, diabetes, hypertension, myocardial infarction, type C lesion, and three-artery lesions were higher in group Ⅲ compared with other two groups （P 〈 0. 05）. The incidences of complications, long-term non-fatal myocardial infarction and revascularization were significantly higher in group Ⅲ than those in groups Ⅰ and Ⅱ （P〈0.05）. cfPWV was positively correlated to incidence of MACE （OR = 1. 98,95% CI ： 1. 039 - 3. 770）. Conclusion cfPWV is closely related to the severity of coronary artery stenosis, and is associated with the increase in incidences of MACE and PCI complication.