冠心病患者血运重建后临床危险因素与预后的相关性分析

目的：探讨冠心病血运重建后影响患者预后的危险因素。方法：选取冠心病血运重建患者106例，根据患者年龄分为A组（年龄＜70岁）61例和B组（年龄≥70岁）45例。收集两组患者的临床资料、辅助检查结果、Syntax评分等资料，并进行对比。通过多因素Cox 分析探讨发生不良心脑血管事件的独立预测因素。结果：A组9．84％合并有心律失常，6．56％既往有脑血管意外病史，显著低于B组（20．00％、17．78％）（均P＜0．05）。两组患者心脏彩色超声多普勒检查各项参数的差异均没有统计学意义（均P＞0．05）。 A组的左回旋支病变比例为60．66％，右冠状动脉病变比例为36．07％，均显著低于B组（755．6％、51．11％）（均P＜0．05）；A组的病变血管数为（2．09±0．83）支，靶病变数为（1．48±0．77）支，均显著少于B组（均 P＜0．05）。 A组再次靶血管血运重建的比例为6．56％，总不良心脑血管事件的发生率为16．39％，均显著低于B组（15．56％、33．33％）（均P＜0．05）。对数秩检验提示，B组的生存率显著低于A组（ P＜0．05）。年龄、病变血管数、收缩压是血运重建后不良心脑血管事件发生的独立预测因素（ OR＝1．131、2．1581、．182，均P＜0．05）。结论：年龄、病变血管数和收缩压是发生血运重建后不良心脑血管事件的独立预测因素，且高龄患者具有更多的危险因素。

Risk Factors in Patients wtih Coronary Heart Disease after Revasculari zation and Relationship with Prognosis

Objective：To investigate the risk factors of patients with coronary heart disease （ CHD） af-ter revascularization and the relationship with prognosis .Method： One hundred and six patients with CHD after revascularization were selected .According to the age , the patients were divided into group A （ age〈70 years with 61 cases） and group B （aged≥70 years with45 cases）.The clinical data, auxiliary examination results, scores of Syntax of the two groups were collected and compared .The independent risk factors of ad-verse cardiovascular events were analyzed by Cox analysis .Rseult：In group A, 9.84%patients with arrhyth-mia, 6.56%patients with cerebral vascular accident history , which were significantly lower than those of group B （20 .00%,17.78%） （ all P〈0.05） .The differences between the two groups of patients with cardiac color doppler ultrasound parameters were not statistically significant （ P〉0.05） .In group A, patients with left circumflex artery disease accounted for 60.66%and 36.07%with right coronary artery disease .Which were significantly lower than those in group B （75.56%,51.11%） （all P〈0.05）.The numbers of diseased vessels in group A were （2.09±08.3） and the target diseased vessels were （1.48±0.77）.Which were significantly less than the group B （P〈0.05）.Patients in group A with target vessel revascularization accounted for 6. 56%and the total adverse cardiovascular event rate was 16.39%.Which were significantly lower than those in group B（15.56%,33 .33%） （ all P〈0.05）.Log-rank test indicated that the survival rate of patients in group B was significantly lower than that of group A （P〈0.05）.Age, the numbers of diseased vessels and systolic blood pressure were independent risk factors of adverse cardiovascular events （ OR=1.131, 2.158, 1.182, P〈0.05）.Conclusion： Age, the numbers of diseased vessels and systolic blood pressure are inde-pendent predictors of adverse cardiovascular events and the elderly patients have mo