代谢综合征对老年冠心病血运重建患者预后的影响

Impact of Metabolic Syndrome on outcome of revasculization in elderly patients with coronary artery disease

目的探讨代谢综合征（MS）对冠心病血运重建患者预后的影响。方法选取860例接受血运重建治疗的患者。记录其临床资料、MS各组成成分和随访期间主要不良心血管事件（MACCE）。分别比较老年患者（年龄≥65岁）和非老年患者（年龄〈65岁）随访期间发生MACCE和未发生MACCE患者MS各指标的差别，并采用Logistic回归分析分析MS对老年冠心病血运重建患者再发MACCE的影响。结果（1）老年患者中发生MACCE者79例（25．24％），非老年组患者中发生MACCE者127例（23．22％），差异无统计学意义（P〉005）。（2）老年患者中发生MACCE者与未发生MACCE者LDL的差异有统计学意义（P〈0．05）；非老年患者中MACCE组MS所占比例明显高于非MACCE组（P〈0．05）。老年患者中MACCE组糖代谢异常、高BMI及MS所占比例均明显高于非MACCE组（P〈0．05）。（3）HDL及MS是老年冠心病患者发生MACCE的独立危险因素（均P〈0．05）。结论MS是老年冠心病血运重建患者发生MACCE的独立危险因素。

Objective To investigate the impact of metabolic syndrome （MS） on the outcome of revasculization in elderly patients with coronary artery disease （CAD）. Methods Eight hundred and sixty patients with CAD who received revasculization therapy were enrolled in the study, including 313 cases aged ≥65 y （elderly group） and 547 cases 〈65 y （control group）. The clinical data including MS and major adverse cardiac and cerebral events （MACCE） were retrospectively analyzed and compared between two groups. Logistic regression was used to analyze the risk factors of MACCE after revasculization therapy. Results The incidence rates of MACCE in elderly and control groups were 25,24% （79/313） and 23.22% （127/547）, respectively （P 〉0.05）. The presence of MS （P=0.014, 0R=3.538, 95%CI 1.297-9.652） was the independent risk factor and HDL level （P=0.038, 0R=0.479, 95%CI 0.239-0.959） was the protective factor for MACCE in the elderly CAD patients following revasculization therapy. Conclusion Metabolic syndrome is a negative factor for outcome of revasculization therapy in elderly patients with cardiovascular disease.