冠状动脉粥样硬化性心脏病患者经皮冠状动脉介入治疗后效果评价及预后预测中应用SYNTAX积分的效果

The value of the SYNTAX score in therapeutic effect and prognosis prediction of percutaneous coronary intervention in patients with coronary atherosclerotic heart disease

目的探讨冠状动脉粥样硬化性心脏病(冠心病)患者经皮冠状动脉介入(PCI)治疗后效果评价、预后预测中应用SYNTAX积分的效果。方法选取2015年2月至2016年8月在青海省心脑血管病专科医院接受PCI治疗的冠心病患者130例,依据术后SYNTAX积分将患者分为3组,A组(SYNTAX积分>32分)42例,B组(SYNTAX积分23～32分)43例,C组(SYNTAX积分<23分)45例。比较3组患者疗效及预后。结果治疗前,3组患者左心室射血分数、左心室舒张末期内径、心排血量比较,差异均无统计学意义(均P>0.05);治疗后12个月,3组左心室射血分数、左心室舒张末期内径、心排血量均较治疗前改善,3组间比较,C组改善较A、B组明显[(68.4±3.4)%比(63.8±3.5)%、(64.3±2.7)%;(62.6±1.2)mm比(46.1±3.4)、(48.2±3.3)mm;(5.5±0.4)L比(4.6±0.3)、(5.0±0.9)L],差异均有统计学意义(均P<0.05)。PCI术后随访12个月,C组心脑血管不良事件发生率明显低于A、B组[4.4%(2/45)比28.6%(12/42)、20.9%(9/43)],差异均有统计学意义(均P<0.05)。随访期间,C组患者住院次数明显少于A、B组[(0.52±0.12)次/年比(1.81±0.22)、(1.21±0.12)次/年],住院时间明显短于A、B组[(7.0±1.0)d比(9.8±1.2)、(8.4±1.3)d],差异均有统计学意义(均P<0.05)。结论对于接受PCI治疗的冠心病患者,术后SYNTAX积分越低表示治疗效果和预后越好。因此,SYNTAX积分可作为此类患者效果评价及预后预测的一个依据。

Objective To analyze the value of the SYNTAX score in therapeutic effect and prognosis prediction of percutaneous coronary intervention （PCI） in patients with coronary atherosclerotic heart disease （CHD）. Methods A total of 130 CHD patients admitted in Qinghai Provincial CardioiCerebrovaseular Disease Hospital from February 2015 to August 2016 were divided into 3 groups according to the SYNTAX score after PCI： group A（ SYNTAX score 〉 32, n = 42） , group B（ SYNTAX score 23-32, n = 43） and group C （SYNTAX score 〈 23, n = 45 ）. Clinical efficiency and. prognosis were analyzed among groups. Results There were no significant differences of left ventricular ejection fraction, left ventricular end-diastolic diameter and cardiac output among 3 groups before treatment （P 〉 0. 05）. Twelve months after treatment, left ventricular ejection fraction, left ventricular end-diastolic diameter and cardiac output in group C were significantly higher than those in group A and B[ （68.4 ±3.4）% vs （63.8 ±3.5）% ,（64.3 ±2.7）%; （62.6 ± 1.2）mm vs （46.1 ±3.4）,（48.2 ±3.3）mm; （5.5 ± 0.4） L vs （4.6 -± 0.3 ）, （5.0 ± 0.9 ） L ] （ P 〈 0.05 ）. During 12 months after treatment, incidence of cardio-cerebrovascular adverse events in group C was significantly lower than that in group A and B [4.4% （2/45） vs 28.6% （ 12/42）, 20.9% （9/43） ] （ P 〈0. 05 ） ; hospitalization times in group C were significantly less than those in group A and B [ （ 0.52 ± 0.12 ） times/year vs （ 1.81 ±0.22 ）, （ 1.21 ±0.12 ） times/year ] ; length of hospitaliza- ti0n time in group C was significantly shorter than that in group A and B [ （7.0 ± 1.0） d vs （9.8 ± 1.2）, （ 8.4 ± 1.3） d] （P 〈 0.05 ）. Conclusion Low SYNTAX score after PCI suggests optimistic therapeutic response and prognosis in CHD patients.