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目的探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)对稳定性冠心病(stable coronary artery disease,SCAD)行经皮冠状动脉介入治疗(percutaneous coronary intervention)术后患者预后的影响。方法采用11倾向性评分方法纳入198例行PCI术的SCAD患者按是否合并COPD分为2组:COPD组和非COPD组,每组99例。比较2组患者2年不良心脑血管事件(全因死亡、心源性死亡、心肌梗死、再次血运重建、支架内血栓和脑卒中独立事件及以上复合终点事件)发生的差异。对合并COPD的独立危险因素采用多因素Logistic回归分析。结果 2组患者全因死亡、心源性死亡、心肌梗死、再次血运重建、支架内血栓、脑卒中发生率比较差异无统计学意义(P>0.05)。COPD组患者复合终点事件发生率明显高于非COPD组(P<0.05)。高龄(OR=1.10,95%CI1.01~1.22,P=0.028)、血肌酐增高(OR=1.16,95%CI 1.02~1.31,P=0.025)和肾小球滤过率降低(OR=1.21,95%CI1.04~1.39,P=0.013)均是合并COPD的独立危险因素。结论合并COPD的冠心病患者有更多的危险因素,临床预后差于无COPD患者。
Objective To investigate the effect of chronic obstructive pulmonary disease (COPD) on the prognosis of patients with stable coronary artery disease (SCAD) after percutaneous coronary intervention. Methods One hundred and eleven patients with SCAD who underwent PCI were divided into two groups according to COPD: COPD group and non-COPD group, 99 cases in each group. Differences in 2-year adverse cardiac and cardiovascular events (all-cause, cardiac death, myocardial infarction, revascularization, stent-thrombotic and stroke independent events and the composite end point events) were compared between the two groups. Independent risk factors for COPD were analyzed by multivariate logistic regression analysis. Results There was no significant difference in incidence of all-cause death, cardiac death, myocardial infarction, revascularization, stent thrombosis and stroke among the two groups (P> 0.05). The incidence of composite end points in COPD patients was significantly higher than that in non-COPD patients (P <0.05). (OR = 1.10, 95% CI1.01 ~ 1.22, P = 0.028), increased serum creatinine (OR = 1.16, 95% CI 1.02-1.31, P = 0.025) and glomerular filtration rate (OR = 1.21 , 95% CI1.04 ~ 1.39, P = 0.013) were independent risk factors for COPD. Conclusions Patients with coronary heart disease complicated with COPD have more risk factors and their clinical outcomes are worse than those without COPD.