PCI患者危险因素的变化对心脏不良事件发生风险的影响

Effects of changes of risk factors in PCI patients on the incidence of cardiac adverse events

目的：探讨经皮冠状动脉介入治疗（ percutaneous coronary intervention,PCI）患者术后危险因素的变化情况,并分析其与心脏不良事件发生风险间的关系。方法选取哈尔滨市某三级甲等医院心内科随访中心数据库中2012年3—9月成功行PCI的患者868例为研究对象,调查患者术后2年血脂、体质量指数、吸烟、血压等危险因素指标的变化情况。结果 PCI术后2年患者的体质量指数和收缩压较术前均无明显变化,而LDL-C、TG、TC均较术前显著下降,HDL-C与术前相比升高,差异有统计学意义（ P〈0.05）。此外,PCI术后2年心脏不良事件风险分层处于低危组、中危组患者的百分比与术前相比均显著升高,极高危层和高危层患者百分比降低,差异有统计学意义（ P〈0.05）。结论 PCI术后患者危险因素的改变导致心脏不良事件风险分层重新分配,由此提示医务人员应加强PCI患者术后二级预防管理,从而改善其生活质量。

Objective To investigate changes of risk factors in patients after percutaneous coronary intervention （ PCI） , and analyze the relationship between it and the risk of occurrence of adverse cardiac events. Methods Totally 868 patients after PCI in the follow-up database center of a tertiary hospital in Harbin from March to September 2012 were selected as the research object. 2 years after surgery, the changes of blood lipid, body mass index （BMI）, smoking, blood pressure and other risk factors were analyzed.Results There was no significant change in BMI and systolic blood pressure 2 years after PCI compared with prior, while low-density lipoprotein cholesterol （ LDL-C） , triglyceride （ TG） and total cholesterol （ TC） significantly decreased compared with preoperative, and high-density lipoprotein cholesterol （HDL-C） increased （P〈0.05）. In addition, risk stratification of adverse cardiac events was in the low-risk and intermediate-risk group 2 years after PCI, and it was significantly higher compared to the previous, and percentage of high-risk group and very high-risk group decreased （P〈0.05）.Conclusions The change of risk factors in PCI patients leads to the reallocation of risk stratification of cardiac adverse events, which reminds that medical staff should adhere to strengthening long-term secondary prevention interventions after PCI, to improve the quality of life of patients.