急性冠状动脉综合征患者PCI术后复发的危险因素分析

Analysis on risk factors of ACS recurrence following PCI treatment

目的了解影响急性冠状动脉综合征(ACS)患者预后的危险因素,制定个体化预防干预方案,为患者的心脏康复二级预防提供科学依据。方法以山西省心血管病医院冠心病监护病房(CCU)的ACS患者为研究对象,采用自行设计的调查问卷对患者的病例资料及院外随访资料进行调查。采用Log-rank检验对不同因素间复发率进行比较;采用Cox回归分析对影响ACS患者预后危险因素进行分析。结果 ACS患者的中位复发时间为(19.27±0.88)个月,Cox回归显示:肥胖、饮食油腻、不规律运动以及抑郁情绪是影响其预后的独立危险因素。结论 ACS患者的预后不能仅靠规律的药物来预防,合理的饮食、鼓励性的心理干预及规律的心脏康复运动同等重要。根据其相关危险因素及自身疾病特征建立有效的二级预防模式体系,进而降低患者再住院及死亡率的发生,提高患者的生活质量。

Objective To analyze the risk factors of the prognosis of ACS, and to provide scientific basis for cardiac rehabilitation of patients. Methods A self designed questionnaire survey was conducted among ACS patients in ICU of Shanxi Cardiovascular Disease Hospital. Log-rank test was used to compare recurrence rates under different factors and Cox regression analysis was used to analyze the risk factors influencing the progno sis of patients with ACS. Results The median time of recurrence for patients with ACS was （19.27±0.88） months, Cox regression analysis showed that obesity, fatty diet, no regular exercise and depression were inde- pendent risk factors affecting the prognosis of ACS. Conclusions Reasonable diet, supportive psychological intervention and regular cardiac rehabilitation exercise are as important as medication for the prognosis of ACS patients. Individualized intervention plan based on the related risk factors and underlying diseases features should be made to reduce the re-hospitalization and mortality of patients, and improve the patientls quality of life.