冠心病合并左心功能不全患者冠状动脉介入治疗预后影响因素分析

【目的】探讨经皮冠状动脉介入治疗（PCI）对冠心病合并左心功能不全患者预后的相关因素。【方法】选择2007年5月至2012年5月本院收治的416例冠心病合并左心功能不全患者，根据其是否行PCI治疗将其分为观察组（n=264）和对照组（n=152），收集其临床资料，包括年龄、性别、高血压病史、糖尿病病史、心功能指标、病变血管情况等资料，并进行2年随访，比较PCI治疗与普通药物治疗对患者预后的影响，logistic回归分析影响冠心病并左心功能不全患者PCI治疗后预后的相关因素。【结果】术后经2年随访共有134例（32．2％）患者死亡，其中观察组63例，对照组71例，观察组患者病死率均显著低于对照组患者，猝死及急性心力衰竭是患者死亡的主要原因。年龄、糖尿病史、高血压病史、心绞痛、LVEF、病变血管支数均与冠心痛合并左心功能不全患者预后相关。【结论】冠心病合并左心功能不全患者行PCI治疗可显著减少患者病死率。年龄、合并糖尿病、高血压病史，有心绞痛症状，LVEF、病变血管支数是决定其预后的重要因素。

Prognostic Factors in Patients with Coronary Heart Disease Combined with Left Ventricular Dysfunction

Objective]To investigate the prognostic factors of percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD) with left ventricular dysfunction .[Methods]The 416 patients with coronary heart disease complicated with left ventricular dysfunction were selected in our hospital from May 2007 to May 2012 .According to the PCI treatment received or not ,the patients were divided into observation group ( n = 264) and control group ( n = 152) ,Clinical data were collected ,including age ,sex ,history of hy‐pertension ,diabetes history ,cardiac function index ,pathological changes of blood vessels and other data ,and 2 years'follow‐up ,the effect of PCI therapy and common drug therapy on the prognosis of patients were com‐pared ,and Logistic regression analysis was used to analyze the prognostic factors of patients with coronary heart disease and left ventricular dysfunction after PCI treatment .[Results]In the 2 years'postoperative follow‐up ,a total of 134 cases (32 .2% ) patients died ,63 cases in the observation group ,71 cases in the control group ,the mortality rate of the observation group was significantly lower than that in the control group ,sud‐den death in patients with acute heart failure is the leading cause of death .Age ,history of diabetes ,hyperten‐sion ,angina pectoris ,LVEF and the number of diseased vessels were related with prognosis of coronary heart disease patients with left ventricular function .[Conclusion] PCI treatment to patients with coronary heart dis‐ease with left ventricular dysfunction can significantly reduce the mortality rate of patients .Age ,diabetes ,hy‐pertension ,angina pectoris ,LVEF ,number of diseased vessels are important factors in determining the prog‐nosis .