急性冠脈綜合征行急診冠狀動脈介入治療患者代謝紊亂分析

Analysis of metabolic disorders in patients with acute coronary syndrome undergoing emergent percutaneous coronary artery intervention

目的分析行急診經皮冠脈動脈介入治療(percutaneous coronary intervention,PCI)的急性冠脈綜合征(acute coronary syndrome,ACS)患者的代謝紊亂特徵與其預後的相關性。方法對2007年~2012年在本院因ACS行急診PCI的223例患者臨床資料完整的病例使用Epidata 3.1進行兩份臨床資料錄入及進行一致性分析。結果與急性ST段抬高性心肌梗死(STEMI)患者相比,非ST段抬高急性冠脈綜合征(NSTE-ACS)患者年齡更大(65.50±12.80vs59.70±13.73,P=0.023),死亡率傾向於更高(8.8%vs2.6%,P=0.075)。STEMI患者的甘油三酯(TG)更高(1.74±1.54vs1.17±0.42,P=0.038)。女性的具有更高的平均年齡(74.22±11.41vs57.13±12.03,P<0.001),合併高血壓率(77.8%vs47.8%,P<0.001),高密度脂蛋白(HDL)(1.21±0.69vs1.02±0.27,<0.001),而男性的TG更高(1.76±1.56vs1.21±0.69,0.023)。中年人較老年人有更高的吸煙率(74.4%vs38.8%,P<0.001)、總膽固醇(CHOL)(4.82±1.17vs4.48±1.03,P=0.037)、低密度脂蛋白(LDL-c)(3.22±1.07vs2.87±0.92,P=0.016)和TG(1.93±1.73vs1.22±0.62,P<0.001)。而老年人的高血壓發生率更高(76.6%vs38.3%,P<0.001)和更高的HDL水平(1.17±0.34vs0.97±0.24,P<0.001)。住院期間死亡的患者中CHOL(3.63±1.03vs4.72±1.11,P=0.012)和LDL-c(2.21±0.97vs3.11±1.0,P=0.021)更低。結論對於行急診PCI的ACS患者,STEMI與NSTE-ACS對比不同性別和年齡有不同的代謝紊亂特徵。

Objective To analyze the metabolic disorders characteristic and their relationships with prognosis of patients who needed emergent percutaneous coronary artery intervention treatment(PCI)for acute coronary syndrome(ACS).Methods The medical record data of 223 cases of ACS who underwent emergency PCI cases in Macao Kiang Wu Hospital were collected and analyzed.Double entry and consistency checking were performed with Epidata 3.1 software.Results Compared with acute ST-segment elevation myocardial infarction(STEMI)patients,the non-ST-segment elevation acute coronary syndrome(NSTE-ACS)patients tended to be older(65.50±12.80 vs 59.70±13.73,P=0.023),and had higher mortality rates(8.8%vs2.6%,P=0.075).STEMI patients had higher blood triglycerides(TG)(1.74±1.54 vs 1.17±0.42,P=0.038).The female patients had higher average age(74.22±11.41 vs 57.13±12.03,P<0.001),hypertension rate(77.8%vs 47.8%,P<0.001)and higher high-density lipoprotein level(HDL)(1.21±0.69 vs 1.02±0.27<0.001).The male patients tended to have higher TG(1.76±1.56 vs 1.21±0.69,0.023).Compared with the older patients,the younger ones tend to have higher HDL lever(74.4%vs 38.8%,P<0.001),and cholesterol level(CHOL)(4.82±1.17 vs 4.48±1.03,P=0.037),low density lipoprotein(LDL-C)(3.22±1.07 vs 2.87±0.92,P=0.016)and TG(1.93±1.73 vs 1.22±0.62,P<0.001).The incidence of hypertension(76.6%vs 38.3%,P<0.001)and HDL levels(1.17±0.34 vs 0.97±0.24,P<0.001)higher in older patients.Among the in-hosiptal death causes,they had lower CHOL(3.63±1.03 vs 4.72±1.11,P=0.012)and LDL-C(2.21±0.97 vs 3.11±1.0,P=0.021).Conclusion The patients with ACS were needed emergency PCI,STEMI and NSTE-ACS,different gender and age have different metabolic disorder characteristics.