摘要
目的 探讨合并泛血管疾病冠状动脉粥样硬化性心脏病(冠心病)患者的临床特点及远期预后。方法 连续纳入2015年1月至12月就诊于保定市第一中心医院的冠心病患者2 014例,根据是否合并泛血管疾病分为泛血管病组(517例)和单纯冠心病组(1 497例)。回顾性分析两组患者的临床特点并进行随访,随访中位时间为4.6年,以发生主要不良心脑血管事件(major adverse cardiovascular and cerebrovascular events,MACCE)为终点。结果 两组患者年龄、性别、体质量指数等比较,差异有统计学意义(P<0.05);泛血管病组冠状动脉病变以左主干、三支病变更常见。多因素Logistic回归分析结果显示,年龄(OR=1.084,95%CI:1.064~1.105,P=0.000)、原发性高血压(高血压)(OR=1.338,95%CI:1.062~1.868,P=0.014)、体质量指数(OR=1.091,95%CI:1.052~1.131,P=0.000)是泛血管疾病的危险因素。Kaplan-Meier生存曲线显示,泛血管病组患者随访时发生MACCE、全因死亡、心肌梗死、缺血性脑卒中和出血的风险均高于单纯冠心病组(P<0.05)。多因素COX分析显示合并泛血管疾病是冠心病患者发生MACCE事件的独立危险因素(HR=1.328,95%CI:1.046~1.687,P=0.020)。结论 合并泛血管疾病冠心病患者的远期预后不佳,进行早期筛查及规范治疗对预后具有重要价值。
Objectives To investigate the clinical characteristics and long-term prognosis of patients with coronary artery disease(CAD)combined with poly-vasculardisease(PVD). Methods A totalof 2 014 consecutive patients in Baoding First Central Hospital from January 2015 to December 2015 were enrolled. According to the history of PVD,patients were classified into two groups:PVD group(n = 517) and single CAD group(n=1 497). The clinical characteristics of the two groups of patients were analyzed retrospectively and the patients were followed up for 4.6 years,and the end point was major adverse cardiovascular and cerebrovascular events(MACCE). Results There were statistically significant differences between the two groups in age,gender,body mass index,et cl(all P<0.05). Left main trunk disease and three branch lesion were more common in PVD group. Multivariate Logistic regression analysis showed age(OR=1.084,95%CI:1.064-1.105,P=0.000),hypertension(OR=1.338,95%CI:1.062-1.868,P=0.014),body mass index(OR=1.091,95%CI:1.052-1.131,P=0.000)were independent related factors of PVD. During the follow-up,patients in PVD group faced a higher risk of MACCE,all-cause death,myocardial infarction,ischemic stroke and bleeding events than single CAD group(P<0.05). COX regression analysis demonstrated that PVD independently associated with a higher risk of MACCE(HR=1.328,95%CI:1.046-1.687,P=0.020). Conclusions The long-term prognosis of CAD patients with PVD is poor,concerns should be raised and active treatment strategies are needed for CAD patients with PVD.
作者
王亚芳
朱烨然
王君
李玉兰
WANG Ya-fang;ZHU Ye-ran;WANG Jun;LI Yu-lan(Department of Geriatrics,Baoding First Central Hospital,Baoding,Hebei 071000,China;Department of Cardiology,Affiliated Hospital of Hebei University,Baoding,Hebei 071000,China;Department of Emergence,Baoding First Central Hospital,Baoding,Hebei 071000,China)
出处
《岭南心血管病杂志》
CAS
2022年第6期530-533,574,共5页
South China Journal of Cardiovascular Diseases
基金
保定市科技计划项目(项目编号:2141ZF078)。
关键词
冠状动脉疾病
泛血管疾病
预后
coronary artery disease
poly-vascular disease
prognosis
作者简介
王亚芳(1988-),女,主治医师,研究方向为冠心病的诊治;通信作者:李玉兰,E-mail:18331018050@163.com。
