经皮冠脉介入治疗术后患者可改变危险因素变化趋势分析

Analysis on the variation trend of risk factors of patients after percutaneous coronary intervention

目的了解经皮冠脉介入治疗（percutaneous coronary intervention，PCI）术后患者的可改变危险因素变化趋势，为患者术后制定健康教育措施提供依据。方法收集2009年9月至2010年3月在哈尔滨某三甲医院成功接受PCI手术患者270例，术后6个月、1年分别进行随访，分析其术前与术后随访时的吸烟、体重指数、血压、血糖、血脂等可变危险因素指标的变化情况。结果术后一年随访资料完整者203例；术前有36．5％的患者吸烟，术后6个月、1年吸烟的患者数分别为35例、26例；高血压病患者术后6个月平均血压较术前呈明显降低，术后1年较术后6个月明显升高，两者比较，差异有统计学意义（P〈0．05）；糖尿病患者术后6个月、1年空腹血糖控制不良，较术前无明显变化；低密度脂蛋白〉3．64mmol／L的患者术后6个月平均低密度脂蛋白较术前降低，术后1年较术前升高，差异有统计学意义（P〈0．05）；体重指数〈24患者的术后1年平均BMI较术前升高，差异有统计学意义（P〈0．05）。结论PCI术后患者的可改变危险因素控制尚不理想，应加强PCI术后患者的长期健康教育与二级预防干预，以减少不良事件的发生，提高生存质量。

Objective To study the variation trend of risk factors of patients after percutaneous coronary intervention so as to provide the evidence for health education after operation treatment. Methods Two hundred seventy participants who underwent percutaneous coronary intervention （ PCI ） between September 2009 and March 2010 were followed up 1 year after PCI. The changes of risk factors, such as smoking, body mass index （BMI）, blood pressure, fasting blood glucose （FBG） and low-density lipoprotein （LDL） were analysed. Results After one year follow-up, there were 203 participants with complete data, and the effective follow-up rate was 85%. About 36.5% preoperative patients were smokers, while after 6 months and 12 months, the smokers were 35 cases（ 17.2% ） and 26 cases（ 12.8% ） ;after 6 months, there was an significantly decreased trend of average blood pressure and an significantly increased trend after one year in the hypertensive patients （ P 〈 0.05 ） ; the FBG change was not good in diabetic patients after 6 months and 1 year, compared with that of preoperative patients; Patients with LDL 〉 3.64 mmolfL had an significantly decreased trend after 6 months and had an increased trend after 12 months （P 〈 0.05 ） ; patients with BMI 〈 24 had an significantly increased trend in average BMI after 12 months （ P 〈 O. 05 ）. Conclusions The variable risk factors control after PCI is far beyond optimal. It＇ s still important to guide patients who received PCI operation to control the variable risk factors. In order to reduce the occurrence of adverse incidents and improve their living qualities, secondary prevention and education work should be enhanced in patients after PCI.