冠心病合并心力衰竭患者死亡风险Cox回归模型分析

Analysis of Cox regression model of death risk in patients with coronary heart disease and heart failure

目的 分析冠状动脉粥样硬化性心脏病(冠心病)合并心力衰竭患者死亡风险及影响因素.方法 连续入选2014年1月至2017年12月冠心病合并心力衰竭患者1484例,随访5年,以死亡为随访终点事件.采用Cox回归方法分析冠心病合并心力衰竭患者死亡的影响因素.结果 中位随访时间23个月,死亡170例.单因素Cox回归分析显示,年龄≥60岁、吸烟、饮酒、高脂血症、水肿、收缩压、硝酸酯类药物和PCI治疗是冠心病合并心力衰竭患者死亡的影响因素.多因素Cox回归显示,年龄≥70岁、水肿、陈旧性心肌梗死和PCI治疗是冠心病合并心力衰竭患者死亡的独立预测因子.结论 与以往心力衰竭研究得出一致结论的基础上,证实了PCI治疗和陈旧性心肌梗死为冠心病合并心力衰竭患者死亡的特异性影响因素,为患者的个体化干预和治疗提供依据.

Objective To analyze the death risk and influencing factors of patients with coronary heart disease and heart failure.Methods A total of 1484 patients with coronary heart disease and heart failure were enrolled from January 2014 to December 2017,followed up for 5 years,and death was used as the end point of follow-up.Cox regression method was used to analyze the influencing factors of death of patients with coronary heart disease and heart failure.Results The median follow-up time was 23 months,with 170 deaths.Univariate Cox regression analysis showed that age≥60,smoking,drinking,hyperlipidemia,edema,systolic blood pressure,nitrate esters and PCI treatment were the influencing factors of death in patients with coronary heart disease and heart failure.Multivariate Cox regression showed that age≥70,edema,old myocardial infarction and PCI treatment were independent predictors of death in patients with coronary heart disease and heart failure.Conclusion On the basis of consistent conclusions from previous heart failure studies,it has been confirmed that PCI treatment and old myocardial infarction are the specific influencing factors of death of patients with coronary heart disease and heart failure,and provide a basis for individualized intervention and treatment of patients.