SYNTAX积分评估冠状动脉2支病变患者经皮冠状动脉介入术后预后的研究

Value of SYNTAX score to the prediction of prognosis of percutaneous coronary intervention for double-vessel coronary heart disease

目的评价SYNTAX积分对冠状动脉2支病变患者经皮冠状动脉介入术后临床预后的预测价值。方法行经皮冠状动脉介入术的冠状动脉2支病变的冠心病患者156例,根据冠状动脉造影结果按SYNTAX积分系统进行评分,并依据SYNTAX积分分为低分组（SYNTAX积分≤22分）65例、中分组（SYNTAX积分为23-32分）49例和高分组（SYNTAX积分≥33分）31例。观察3组临床主要不良心脑血管事件（major adverse cardiac and cerebral event,MACCE）发生率,采用Cox比例风险模型分析SYNTAX积分与冠状动脉2支病变患者经皮冠状动脉介入术术后MACCE发生的关系。结果 145例患者完成随访,随访率92.9%,随访时间（15.8±5.2）个月;所有患者SYNTAX积分为10-51（25.3±10.7）分;低分组、中分组和高分组患者经皮冠状动脉介入术术后MACCE发生率分别为4.6%、10.2%和22.6%,组间比较差异均有统计学意义（P〈0.05）;多因素分析结果显示SYNTAX积分是冠状动脉2支病变患者经皮冠状动脉介入术术后MACCE发生的独立预测因素（HR=1.05,95%CI：1.01-1.09,P=0.017）。结论SYNTAX积分对冠状动脉2支病变患者经皮冠状动脉介入术术后的临床预后有预测意义,SYNTAX积分增加,临床MACCE发生率升高。

Objective To evaluate the value of SYNTAX score to predicting the prognosis of percutaneous coronary intervention（PCI）for double-vessel coronary heart disease.Methods A total of 156 patients receiving PCI for doublevessel coronary heart disease were scored according to SYNTAX score system on the basis of coronary angiography results,and were divided into low SYNTAX score group（SYNTAX score ≤22,n=65）,medium SYNTAX score（SYNTAX score：23to 32,n=49）,and high SYNTAX score（SYNTAX score≥33,n=31）.The incidence of major adverse cardiac and cerebral event（MACCE）was observed in three groups.Multivariate Cox proportional hazard regression analysis was performed to evaluate the correlation between SYNTAX score and the incidence of MACCE.Results The follow-up survey was done in 145patients（92.9%）for（15.8±5.2）months.The overall SYNTAX score ranged from 10 to 51（25.3±10.7）.The incidences of MACCE were 4.6%,10.2% and 22.6% respectively in low,medium and high SYNTAX score groups,showing significant differences（P〈0.05）.Multivariate analysis showed that SYNTAX score was an independent predictor for MACCE after PCI（HR=1.05,95%CI：1.01 to 1.09,P=0.017）.Conclusion SYNTAX score has the predicting value to evaluating the prognosis of double-vessel coronary heart disease undergoing PCI.The incidence of MACCE increases along with the increase of SYNTAX score.