非ST段抬高型急性冠脉综合征患者的介入治疗现状及影响因素分析

Current situation and related factors of coronary intervention treatment in patients with non ST-elevation acute coronary syndrome

目的探讨非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者经皮冠状动脉介入治疗(PCI)现状及影响因素。方法收集2008年1月至2015年12月洛阳市中心医院出院诊断为NSTE-ACS患者的临床资料,包括性别、年龄、吸烟、饮酒、高血压病、2型糖尿病、陈旧性脑梗死、慢性肾脏病、陈旧性心肌梗死,血糖、血脂、肌酐、心肌标记物,冠状动脉造影及介入治疗情况等,共收集475例NSTE-ACS患者。其中214例接受冠状动脉造影术,分为PCI组(n=109)与非PCI组(n=105),比较两组间一般资料,多因素Logistic回归分析冠状动脉介入治疗的影响因素。结果 PCI组(n=109)与非PCI组(n=105)相比,男性(67.0%vs 51.4%,P<0.01)、非ST段抬高型心肌梗死(NSTE-MI)(32.1%vs 9.5%,P<0.01)、心功能Ⅱ级(50.9%vs 30.4%,P<0.01)比例较高,空腹血糖水平(6.5±2.6mmol/L vs 5.8±1.9mmol/L,P=0.02)偏高。两组吸烟、饮酒、高血压病等心血管危险因素、肌酐、血脂水平差异无统计学意义。多因素Logistic回归分析显示男性、心功能Ⅱ级、NSTE-MI是PCI治疗的支持因素。结论本中心NSTE-ACS患者冠状动脉介入治疗率为22.9%,男性、心功能Ⅱ级、NSTE-MI是介入治疗的支持因素。

Objective To analyze current situation and related factors of percutaneous coronary intervention （PCI） in patients with nonST segment elevated acute coronary syndrome（NSTE-ACS）. Methods 475 NSTE-ACS patients in our hospital were enrolled from 2008 to 2015. The clinical data included gender, age, smoking, drinking, hypertension, diabetes mellitus, stroke, chronic kidney disease, chronic myocardial infarction, and level of blood sugar, blood fat, creatinine, myocardial biomarkers, and the status of coronary angiography and interventional therapy. Comparison was made in the clinical information between PCI group and non PCI group, the association factors of PCI in multiple logistic regression mode were analyzed. Results Compared to non-PCI group （n=105）,PCI group （n=109） had higher percentage of male（67.0% vs 51.4%,P〈0.01）, NSTE-MI （32.1% vs 9.5%,P〈0.01） and heart function class Ⅱ （50.9% vs 30.4%,P〈0.01）,and higher fasting bloodglucose （6.5±2.6 vs 5.8±1.9 mmol/L,P=0.02）. The percentage of cardiovascular risk factors, and serum creatinine, triglycerides level were not different significantly between two groups. The male, heart function grade Ⅱ,and NSTE-MI were influence factors of PCI in the multiple logistic regression mode. Conclusion The rate of coronary intervention in NSTE-ACS patients was 22.9% in our hospital,the male, function grade,and MI are influence factors of PCI.