动脉粥样硬化患者PCI术后短期不良预后的危险因素

Risk factors of short-term poor prognosis in patients with atherosclerosis after percutaneous coronary intervention

目的探讨动脉粥样硬化患者经皮冠状动脉介入治疗(PCI)术后短期不良预后的危险因素。方法选择2019年1月至2021年6月于河南省直第三人民医院住院的动脉粥样硬化并行PCI的患者125例作为研究对象,随访患者短期不良预后的发生情况,并收集临床资料分析短期不良预后的危险因素。结果125例患者均成功完成PCI,手术时间为41~58 min,平均手术时间(50.12±2.65)min,术后随访发现,再发心绞痛6例、心肌梗死7例、心律失常6例、血运重建5例和心力衰竭7例,再发不良预后率为24.80%。根据预后情况分为预后不良组(n=31)和预后良好组(n=94),两组在性别、糖尿病、饮酒、独居、首次PCI及家族史比较,差异均无统计学意义(P>0.05);预后不良组年龄、合并高血压、高脂血症、吸烟史、冠状动脉(冠脉)病变支数多支、心功能分级均高于预后良好组,辅助用药、术前他汀类治疗比较均低于预后良好组,差异有统计学意义(P<0.05)。多因素非条件Logistic分析显示,年龄、高血压、高脂血症、辅助用药、饮酒、冠脉病变支数、心功能分级、术前他汀类治疗均为PCI术后短期不良预后的独立危险因素(P<0.05)。结论动脉粥样硬化患者PCI术后短期不良预后发生率较高,应重点关注危险因素并及时干预。

Objective To discuss the risk factors of short-term poor prognosis in patients with atherosclerosis(AS)after percutaneous coronary intervention(PCI).Methods AS patients undergone PCI(n=125)were chosen from the Third People’s Hospital of Henan Province from Jan.2019 to June 2021.The incidence of short-term poor prognosis was followed up,and clinical materials were collected for analyzing the risk factors of short-term poor prognosis in all patients.Results All 125 patients were received successfully PCI,and the operation time was from 41 min to 58 min[averagely(50.12±2.65)min].The results of postoperation follow-up showed that there were 6 cases of relapsed angina pectoris,7 cases of myocardial infarction,6 cases of arrhythmia,5 cases of revascularization and 7 cases of heart failure.The rate of relapsed poor prognosis was 24.80%.All patients were divided,according to their prognosis,into poor prognosis group(n=31)and good prognosis group(n=94).The differences in gender,diabetes,drinking,living alone,first-time PCI and family history had no statistical significance between 2 groups(P>0.05).The gender,hypertension,hyperlipidemia,smoking history,multi-vessel lesions of coronary artery and heart function classification were all higher,and adjuvant drugs and preoperative statin treatment were lower in poor prognosis than those in good prognosis(P<0.05).The results of multi-factor unconditional Logistic analysis showed that age,hypertension,hyperlipidemia,adjuvant drugs,drinking,diseased vessels of coronary artery,heart function classification and preoperative statin treatment were all independent risk factors of short-term poor prognosis after PCI(P<0.05).Conclusion The incidence rate of short-term poor prognosis after PCI is higher in AS patients,so risk factors should be paid more attention to and be intervened in time.