冠心病心绞痛患者临床特点及不良心血管事件发生的危险因素分析

Clinical characteristics and risk factors of major adverse cardiovascular events in patients with coronary heart disease and angina pectoris

目的探讨冠状动脉粥样硬化性心脏病(冠心病)心绞痛患者临床特点及不良心血管事件发生的危险因素。方法选择2019年1月至2022年12月于阜阳市人民医院收治的冠心病心绞痛患者92例,根据是否发生不良心血管事件分为事件组(n=34)和对照组(未发生不良心血管事件,n=58),收集患者临床资料,分析冠心病心绞痛患者临床特点及不良心血管事件的危险因素。结果事件组患者心率、心绞痛发作频率、疼痛持续时间水平均显著高于对照组,差异有统计学意义(P<0.05);单因素分析显示,两组患者在性别、冠心病家族史比较,差异无统计学意义(P>0.05);事件组年龄、肥胖、吸烟史、高血压、糖尿病、高血脂症、肌钙蛋白T(cTnT)、超敏C反应蛋白(CRP)、N末端脑钠肽前体(NT-proBNP)均高于对照组,治疗依从性低于对照组(P<0.05);多因素非条件Logistic分析显示,年龄、肥胖、吸烟史、高血压、糖尿病、高血脂症、CTnT升高、CRP升高、NT-proBNP升高及治疗依从性均是冠心病心绞痛患者发生不良心血管事件的独立危险因素(P<0.05)。结论冠心病心绞痛患者发生不良心血管事件的危险因素较多,临床应密切关注以降低不良心血管事件的发生率。

Objective To discuss the clinical characteristics and risk factors of major adverse cardiovascular events(MACE)in patients with coronary heart disease(CHD)and angina pectoris(AP).Methods The patients with CHD+AP(n=92)were chosen from People’s Hospital of Fuyang City from Jan.2019 to Dec.2022.All patients were divided,according to occurrence state of MACE,into MACE group(n=34)and control group(n=58).The clinical materials were collected,and clinical characteristics and risk factors of MACE were analyzed in patients with CHD+AP.Results The levels of heart rate(HR)and AP seizure frequency and duration were significantly higher in MACE group than those in control group and differences had statistical significance(P<0.05).The results of single-factor analysis showed that the differences in gender and CHD family history had no statistical significance(P>0.05),and age,obesity,smoking history,hypertension,diabetes,hyperlipidemia,cardiac troponin T(cTnT),high sensitivity C-reactive protein(hs-CRP)and N-terminal pro-brain natriuretic peptide(NT-proBNP)all were higher,and treatment compliance was lower in MACE group than those in control group(P<0.05).The results of multi-factor non-conditional Logistic analysis showed that age,obesity,smoking history,hypertension,diabetes,hyperlipidemia,increased CTnT,CRP and NT-proBNP,and treatment compliance were independent risk factors of MACE in patients with CHD+AP(P<0.05).Conclusion There are many risk factors of MACE in patients with CHD+AP,which should be paid close attention to for reducing incidence of MACE.