早发冠心病PCI术后发生不良心血管事件的危险因素分析

Risk factors of adverse cardiovascular events in patients with premature coronary artery disease after percutaneous coronary intervention

目的探讨早发冠状动脉粥样硬化性心脏病(冠心病)经皮冠状动脉介入治疗(PCI)术后发生不良心血管事件的危险因素。方法选择2020年1月至2022年6月于青岛市市立医院就诊的早发冠心病行PCI患者115例,随访不良心血管事件发生情况,根据随访结果分为再发组24例,对照组91例。收集患者临床资料,分析再发不良心血管事件的危险因素。结果本研究纳入的115例患者均成功完成PCI,手术时间为47~63 min,平均手术时间(51.12±2.72)min,术后随访再发心绞痛5例、心肌梗死9例、心律失常6例、心力衰竭4例,再发不良预后发生率20.87%。单因素分析显示,两组患者性别、独居、首次手术、运动及家族史比较差异无统计学意义(P>0.05);两组年龄、高血压、高血脂、糖尿病、辅助用药、NYHA心功能分级、吸烟史、饮酒、冠状动脉(冠脉)病变支数比较,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、糖尿病、辅助用药、NYHA心功能分级、吸烟、饮酒、冠脉病变支数均是早发冠心病PCI术后发生不良心血管事件的独立危险因素(P<0.05)。结论早发冠心病PCI术后不良心血管事件发生率较高,临床应针对危险因素进行干预。

Objective To investigate the risk factors of adverse cardiovascular events(ACE)in patients with premature coronary artery disease(PCAD)after percutaneous coronary intervention(PCI).Methods PCAD patients undergone PCI(n=115)were chosen from Qingdao Municipal Hospital from Jan.2020 to June 2022.The incidence of ACE was followed up and clinical material were collected from the patients.All patients were divided,according to follow-up results,into relapsed group(n=24)and control group(n=91).The risk factors of relapsed ACE were analyzed.Results There were 115 patients with successful PCI,operation time was from 47 min to 63 min,and mean operation time was(51.12±2.72)min.The postoperative follow-up showed that there were 5 patients with relapsed angina pectoris,9 with myocardial infarction,6 with arrhythmias,and 4 with heart failure,and incidence rate of poor prognosis was 20.87%.The results of single-factor analysis showed that comparison in sex,living alone,first-time operation,sport and family history had no statistical difference between 2 groups(P>0.05).The differences in age,hypertension,hyperlipidemia,diabetes,adjuvant medications,NYHA classification of heart function,smoking history,drinking,number of diseased coronary vessels had statistical significance between 2 groups(P<0.05).The results of multi-factor unconditional Logistic analysis showed that age,hypertension,hyperlipidemia,diabetes,adjuvant medications,NYHA classification of heart function,smoking history,drinking,number of diseased coronary vessels all were independent risk factors of ACE incidence in PCAD patients after PCI(P<0.05).Conclusion The incidence rate of ACE is higher in patients with PCAD after PCI,and the risk factors should be intervened in clinical practice.