急性冠状动脉综合征患者预后与冠状动脉严重病变程度的相关性

The correlation between prognosis and severity of coronary lesions in senile patients with acute coronary syndrome

目的探讨急性冠状动脉综合征(Acute coronary syndrome,ACS)患者预后与冠状动脉病变严重程度的相关性。方法选择2018年5月至2019年6月本院收治的老年ACS患者200例,采用Gensini积分方法评价冠状动脉病变的严重程度,根据病变的严重程度,将患者分为轻度组(n=120)和中重度组(n=80),分析Gensini积分与冠状动脉病变程度相关性。随访半年,根据是否发生主要不良心血管事件(Major adverse cardiovascular events,MACE)分为MACE组(n=18)和非MACE组(n=182),分析影响MACE的因素。结果较轻度组,中重度组高血压占比、BMI值、TC、TG水平均较高,差异有统计学意义(P<0.05);高血压史、BMI、TC、TG与Gensini积分呈正相关(r>0,P<0.05);MACE组BMI值、Gensini积分均高于非MACE组,差异有统计学意义(P<0.05);多因素Logistic回归分析发现,Gensini积分是引起MACE的危险因素(OR>1,P<0.05)。结论高血压史、BMI、TC与TG水平与冠状动脉Gensini积分呈正相关,与冠状动脉病变严重程度密切相关,及早进行有效控制或检测,可延缓冠状动脉病变的进展,Gensini积分是老年ACS评估预后的独立危险因素,可预测患者术后心血管不良事件的风险。

Objective To investigate the correlation between prognosis and severity of coronary lesions in senile patients with acute coronary syndrome(ACS).Methods A total of 200 senile patients with ACS who admitted in the hospital from May 2018 to June 2019 were selected.The severity of coronary artery lesion was evaluated by Gensini score.The patients were divided into mild group(n=120)and moderate-severe group(n=80)and the correlation between Gensini score and the severity of coronary lesions was analyzed.The follow-up lasted for six months.The patients were divided into major adverse cardiovascular events(MACE)group(n=18)and non-MACE group(n=182)according to whether or not occurred MACE,and the factors affecting MACE were analyzed.Results The proportion of hypertension,BMI,TC and TG in moderate-severe group were higher than those in mild group(P<0.05).The hypertension history,BMI,TC and TG were positively correlated with Gensini score(r>0,P<0.05).The BMI and Gensini score in MACE group were higher than those in non-MACE group(P<0.05).Multiple Logistic regression analysis showed that Gensini score was the risk factor for MACE(OR>1,P<0.05).Conclusion Hypertension history,BMI,TC,and TG levels are positively correlated with Gensini score of coronary artery,which are closely related to the severity of coronary lesions.They can be effectively controlled or detected to delay the progression of coronary artery disease.Gensini score is an independent risk factor for the prognosis of senile ACS,which can predict the risk of postoperative adverse cardiovascular events in patients.