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目的探讨颈动脉斑块逆转程度在评估急性冠脉综合征(ACS)患者行经皮冠状动脉介入(PCI)治疗近期预后中的价值。方法将180例行PCI治疗的ACS患者分为颈动脉斑块明显逆转组(A组,88例)和无明显逆转组(B组,92例)。观察两组术后主要不良心血管事件(MACE)的发生情况,并分析其与颈动脉斑块逆转程度的关系。结果两组患者手术前后BMI以及生化指标比较均无统计学差异(P>0.05)。与B组相比,A组斑块面积和术后随访1年的MACE发生率减少[(48.3±22.7)mm~2 vs.(57.2±33.9)mm~2和18.2%vs.32.6%](P<0.05)。Cox多因素分析显示,斑块面积下降率是ACS患者PCI术后发生MACE的独立保护因素[RR=0.000,95%CI(0.000~0.090),P<0.05]。结论 PCI术后颈动脉斑块明显逆转的ACS患者的MACE发生率更低,预后更好。
Objective To investigate the value of carotid plaque reversal in evaluating the short-term prognosis of patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods One hundred and eighty PCI patients undergoing PCI were divided into three groups: carotid plaque was significantly reversed (group A, n = 88) and group without reversal (group B, n = 92). The incidence of major adverse cardiovascular events (MACE) in both groups was observed and the relationship between them and the degree of carotid plaque reversal was analyzed. Results There was no significant difference in BMI and biochemical indexes between the two groups before and after operation (P> 0.05). Compared with group B, the plaque area in group A and the incidence of MACE after one year of follow-up were significantly decreased (48.3 ± 22.7 mm 2 vs 57.2 ± 33.9 mm 2 vs 18.2% vs. 32.6% P <0.05). Cox multivariate analysis showed that plaque area reduction rate was an independent protective factor of MACE after PCI in ACS patients [RR = 0.000, 95% CI (0.000-0.090), P <0.05]. Conclusions The incidence of MACE in ACS patients with significant reversal of carotid artery plaque after PCI is lower and the prognosis is better.