代谢综合征对急性ST段抬高型心肌梗死患者远期预后的影响

Effect of metabolic syndrome on long-term prognosis of patients with acute myocardial infarction undergoing successful percutaneous coronary intervention

目的 探讨代谢综合征对急诊经皮冠状动脉介入治疗的急性ST段抬高型心肌梗死患者远期预后的影响.方法 按NCEP-ATPⅢ标准将561例急性心肌梗死患者分为代谢综合征组（259例）和非代谢综合征组（302例）,比较两组患者一年内主要不良心脏事件（MACE）.结果 259例患者符合代谢综合征标准,占46.2％.与非代谢综合征组相比,代谢综合征组MACE发生率较非代谢综合征组高,差异具有统计学意义（P＜0.05）.在校正高血压、糖尿病、血脂异常、冠脉多支病变等组间不匹配因素后,logistic多元回归分析显示代谢综合征仍是MACE的危险因素（优势比：2.834,95％可信区间：1.363～4.857,P=0.002）.结论 代谢综合征是经皮冠状动脉介入治疗的急性ST段抬高心肌梗死患者一年内MACE的危险因素之一.

Objective To assess the predictive value of metabolic syndrome on long-term prognosis of patients with acute myocardial infarction undergoing successful percutaneous coronary intervention. Methods 561 patients with acute myocardial infarction undergoing successful pereutaneous coronary intervention were divided into two groups according to the standard of NECP-ATPⅢ ： metabolic syndrome groups （n=259） and non metabolic syndrome groups （n=302）. Major adverse cardiac events （MACE） were recorded and compared between the two groups. Results There were totally 259 patients suffering from metabolic syndrome （46.2%）. MACE were in- creased in metabolic syndrome groups compared with non metabolic syndrome groups （P〈0.05）. After adjustments for hypertension, diabetes, hyslipidaemia, the number of diseased vessels, multi-variables logistic analysis showed that metabolic syndrome was an independent predictive factor for MACE （odds ratios： 2.834, 95% confidence intervals： 1.363-4.857, P=-0.002）. Conclusion Metabolic syndrome is an independent predictive factor for MACE of patients with acute myocardial infarction undergoing successful percutaneous coronary.