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目的分析影响经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后死亡的危险因素。方法选取2006年1月1日~2011年6月30日初次在北京大学人民医院、北京东直门中医院、沧州市中心医院和洛阳市中心医院4家医院接受PCI治疗并置入药物洗脱支架的冠心病患者为研究对象,对其术后死亡率以及影响死亡率的相关因素进行分析。结果共随访患者3 511人(85.4%),PCI术后死亡率是4.6%(161/3 511),多因素分析结果显示:年龄(HR=1.086,95%CI:1.059~1.113,P<0.001)、糖尿病(HR=1.807,95%CI:1.205~2.709,P=0.004)、吸烟(HR=1.873,95%CI:1.205~2.709,P=0.002)、贫血(HR=1.909,95%CI:1.266~2.879,P=0.002)、左心射血分数<50%(HR=2.546,95%CI:1.558~4.162,P<0.001)和双联抗血小板治疗(dual antiplatelet therapy,DAPT)时间<1年(HR=0.029,95%CI:0.013~0.067,P<0.001)与患者PCI术后死亡率相关。结论年龄、糖尿病、吸烟、贫血、心功能不良和DAPT时间<1年是影响冠心病患者PCI术后死亡率的危险因素,应该给予重视和合理干预。
Objective To analyze the risk factors of postoperative death after percutaneous coronary intervention (PCI). Methods From January 1, 2006 to June 30, 2011, we first received PCI at Peking University People’s Hospital, Beijing Dongzhimen Hospital of Traditional Chinese Medicine, Cangzhou Central Hospital and Luoyang Central Hospital, and placed them into drug-eluting stents Patients with coronary heart disease as the research object, its postoperative mortality and the impact of mortality related factors were analyzed. Results A total of 3 511 patients (85.4%) were followed up. The mortality rate after PCI was 4.6% (161/3 511). The results of multivariate analysis showed that age (HR = 1.086,95% CI: 1.059 ~ 1.113, P <0.001) (HR = 1.873, 95% CI: 1.205-2.709, P = 0.002), and anemia (HR = 1.909, 95% CI: 1.807, 95% CI: 1.205-2.709, P = 0.004) (HR = 2.546, 95% CI: 1.558-4.162, P <0.001) and dual antiplatelet therapy (DAPT) <1 (P <0.001) Year (HR = 0.029, 95% CI: 0.013-0.067, P <0.001) were associated with postoperative PCI mortality. Conclusions Age, diabetes, smoking, anemia, cardiac dysfunction and DAPT time <1 year are risk factors of postoperative PCI mortality in patients with coronary heart disease, and attention and reasonable intervention should be given.