高龄急性冠状动脉综合征患者介入治疗预后影响因素分析

Factors Influencing Prognosis of Interventional Therapy in Elderly Patients with Acute Coronary Syndrome

目的探讨高龄急性冠状动脉综合征(ACS)患者的临床特征及介入治疗的预后影响因素。方法回顾性分析我院2012年8月-2015年8月行急诊冠状动脉介入(PCI)治疗的ACS患者的临床资料,对影响预后的因素行单因素和多因素Cox回归分析。结果高龄ACS患者中女性患者比例较高,且合并高血压、高脂血症患者比例较大,以KillipⅢ级常见,高龄组吸烟者多(P<0.05)。高龄ACS患者PCI治疗后影响因素可能与性别、Killip分级、吸烟史、高血压、心源性休克、高脂血症相关(P<0.05);多因素Cox回归分析结果显示,患者性别(女性)、高血压病史、存在心源性休克为影响ACS患者预后的危险因素(P<0.01)。结论高龄ACS女性患者所占比例较大,并存心血管疾病较多,在PCI手术后控制并存疾病的发病率,可提高ACS患者预后效果。

Objective To investigate the factors that influence the prognosis of elderly patients with acute coronary syn- drome （ACS） after interventional therapy. Methods The clinic data of ACS patients undergoing percutaneous coronary interven- tion （PCI） in our hospital between August 2012 and August 2015 were collected for analysis,and the factors that influenced prog- nosis were studied. Results A large proportion of the elder patients of ACS were females and combined with high blood pressure and HLP. Killip Ⅲ was common and there were many smokers among these patients （P〈0.05）. After interventional therapy, the influencing factors were gender, Killip grading, smoking history, high blood pressure, CGS and HLP （P〈0. 05 ）. Muhiariable Cox regression analysis showed that gender （female） ,high blood pressure history and cardiac shock were risk factors that influenced prognosis of ACS （P〈0.01）. Conclusion A large proportion of elderly ACS patients arefemales and combined with cardiovascular disease. Control of the incidence of coexistent disease after PCI can improve prognosis of ACS.