急性冠脉综合征患者PCI术预后不良的危险因素分析

Risk factors on unfavourable prognosis of acute coronary syndromes patients after PCI operation

目的:探讨急性冠脉综合征(ACS)经皮冠状动脉介入治疗(PCI)术预后不良发生率及其相关危险因素,为改善ACS预后提供依据。方法:将确诊的192例行PCI术的ACS患者依据预后情况分为预后不良组(N=45)和预后良好组(N=147),对所有患者进行问卷调查,采用单因素比较分析和多因素Logistic回归来筛选可能影响ACS预后不良的危险因素。结果:ACS患者预后不良率为23.4%(45/192);多因素Logistic回归分析结果显示年龄(OR=1.288)、无院前急救(OR=6.482)、NT-Pro BNP(OR=1.800)、心肌肌钙蛋白(OR=2.861)、冠状造影(OR=3.684)为预后不良的危险因素,而左心室射血分数(OR=0.687)则为保护因素。结论:ACS患者PCI术后仍有较高的心血管不良事件发生,其独立危险因素包括高龄、无院前急救、高水平NT-Pro BNP和心肌肌钙蛋白、冠状造影病变多及左心室射血分数差。

Objective ]To explore the incidence rate and correlated risk factors of unfavourable prognosis of acute coronary syn-dromes （ACS） patientsafter percutaneous coronary intervention （PCI）operation and to provide basis for improving prognosis of ACS .[Method] 192 definite cases of ACS patients through PCI operation were divided into unfavourable prognosis group （n=45） and eusemia group （n= 147 ） . All of the patients were investigated by questionnaire and then the risk factors of un-favourable prognosis of ACS were screened by single factor comparative analysis and multiple factors Logistic Regression method .[Result] The incidence rate of unfavourable prognosis of ACS was 23 .4% （45/192） .Multiple factors analysis result showed that the risk factors of unfavourable prognosis of ACS included in age （OR=1 .288 ） ,without pre-hospital care （OR=6 .482） ,NT-ProBNP （OR=1 .800） ,cardiac troponin （OR=2 .861） and coronal visualization （OR=3 .684） ,but left ventricular ejection fraction was the protective factor （OR=0 .687） .[Conclusion]ACS patients after PCI operation still exist a high incidence rate of unfavourable prognosis .The independent risk factors of unfavourable prognosis of ACS include in high age ,without pre-hospital care ,high levels of NT-ProBNP ,cardiac troponin ,many pathological changes of coronal visual-ization and bad left ventricular ejection fraction .