体质量指数对高龄冠心病患者经皮冠状动脉介入术后远期预后的影响分析

Effect of Body Mass Index on Long-term Prognosis of Elderly Patients with Coronary Heart Disease after Percutaneous Poronary Interventio

【目的】探讨体质量指数(body mass index,BMI)对高龄冠心病患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后远期预后的影响。【方法】选择2014年6月至2018年12月在本院诊治的≥60岁稳定型冠心病患者278例,按照BMI分为正常体重组(BMI为18.5~24.0 kg/m2,n=81)、超重组(BMI为24.1~28.0 kg/m2,n=134)、肥胖组(BMI>28.0 kg/m2,n=63),收集入组患者临床资料,分析BMI对患者长期预后的影响。【结果】三组患者在年龄、糖尿病、高血压、高脂血症例数、白细胞(WBC)、血小板(PLT)、血红蛋白(Hb)、高密度脂蛋白胆固醇(HDL-C)及总胆固醇(TC)水平等一般资料比较差异无统计学意义(P<0.05)。正常体重组术后2年死亡率和不良事件发生率分别为8.64%、32.10%,均显著高于超重组2.24%、17.16%和肥胖组的1.59%、11.11%,其差异均有统计学意义(P<0.05)。Logistic回归分析显示:年龄≥70岁、腰围≥90 cm、合并糖尿病、合并高血压、合并高血脂、BMI正常等均为稳定型冠心病患者PCI术后发生不良事件的独立危险因素(P<0.05)。【结论】BMI≥24.0 kg/m2的高龄冠心病患者虽较正常BMI指数患者具有更多的危险因素,但其PCI术后远期预后优于正常BMI患者,且死亡风险较正常BMI患者低。

【Objective】To analyze the effect of body mass index(BMI)on the long-term prognosis of elderly patients with coronary heart disease after percutaneous coronary intervention(PCI).【Methods】From June 2014 to December 2018,278 patients with stable coronary heart disease aged over 60 years were selected and divided into normal weight group(BMI of 18.5-24.0 kg/m2,n=81),overweight group(BMI of 24.1-28.0 kg/m2,n=134)and obesity group(BMI>28.0 kg/m2,n=63)according to BMI.The clinical data of the patients in the admitted were collected to analyze the influence of BMI on the long-term prognosis of patients.【Results】There were no significant differences in age,diabetes mellitus,hypertension,hyperlipidemia,white blood cell(WBC),platelet(PLT),hemoglobin(HB),high density lipoprotein cholesterol(HDL-C)and total cholesterol(TC)levels among the three groups(P<0.05).The 2-year mortality and incidence of adverse events in normal weight group were 8.64%and 32.10%,which were significantly higher than those in overweight group(2.24%,17.16%)and obesity group(1.59%and 11.11%)(P<0.05).Logistic regression analysis showed that age≥70 years,waist circumference≥90 cm,diabetes mellitus,hypertension,hyperlipidemia and normal BMI were independent risk factors for adverse events after PCI in patients with stable coronary heart disease(P<0.05).【Conclusion】Although the elderly patients with coronary heart disease with BMI≥24.0 kg/m2 have more risk factors than those with normal BMI,their long-term prognosis after PCI is better than those with normal BMI,and the risk of death is lower than that of patients with normal BMI.