论文部分内容阅读
目的探讨颈动脉粥样硬化对早发冠心病患者近期预后的预测价值。方法对132例早发冠心病患者应用B型超声检测颈动脉内膜中膜厚度和斑块情况,并进行随访,判断颈动脉粥样硬化对早发冠心病患者平均2年随访期间心脏性死亡、非致命性心肌梗死以及再发心绞痛等心血管事件的预测价值。结果73例(55%)患者合并颈动脉粥样硬化,59例(45%)未合并颈动脉粥样硬化。颈动脉粥样硬化组年龄、患高血压比例、冠心病家族史、患糖尿病比例以及血浆低密度脂蛋白胆固醇水平明显高于非颈动脉粥样硬化组(P<0.05~0.01);两组疾病临床表型以及冠状动脉病变支数特征无差异(P>0.05)。两组介入手术均获得成功。随访期间,颈动脉粥样硬化组心脏性死亡、非致命性心肌梗死及再发心绞痛事件分别为0、2和12例;非颈动脉粥样硬化组分别为0、1和3例;颈动脉粥样硬化组主要不良心血管事件明显高于非颈动脉粥样硬化组(19.4%比7.1%,P<0.05)。多因素Logistic回归分析,吸烟、高低密度脂蛋白胆固醇水平和颈动脉超声阳性(OR=5.22,95%CI为1.34~10.25,P=0.005)是早发冠心病介入术后近期主要不良心血管事件的独立预测指标。结论颈动脉粥样硬化对早发冠心病介入治疗后近期预后有预测价值,合并颈动脉粥样硬化的早发冠心病患者介入治疗术后近期主要不良心血管事件增加。
Objective To investigate the predictive value of carotid atherosclerosis in the prognosis of patients with premature coronary artery disease. Methods The carotid intima-media thickness and plaque in 132 patients with premature coronary heart disease were examined by B-mode ultrasound and followed up to determine the effect of carotid atherosclerosis on the average 2-year follow-up of patients with premature coronary heart disease , Non-fatal myocardial infarction and recurrent angina and other cardiovascular events predict the value. Results Of 73 patients (55%) with carotid atherosclerosis, 59 (45%) did not have carotid atherosclerosis. Carotid atherosclerosis group age, the proportion of patients with hypertension, family history of coronary heart disease, diabetes mellitus and plasma low density lipoprotein cholesterol levels were significantly higher than non-carotid atherosclerosis group (P <0.05 ~ 0.01); two groups of diseases Clinical phenotypes and coronary artery lesions no difference in characteristics (P> 0.05). Both interventions were successful. During follow-up, cardiac death, non-fatal myocardial infarction and recurrent angina were 0, 2 and 12, respectively in the carotid atherosclerosis group; 0, 1 and 3 in the non-carotid atherosclerosis group; The major adverse cardiovascular events in the atherosclerotic group were significantly higher than those in the non-carotid atherosclerosis group (19.4% vs. 7.1%, P <0.05). Multivariate Logistic regression analysis showed that smoking, high and low density lipoprotein cholesterol levels and carotid artery ultrasound (OR = 5.22, 95% CI 1.34-10.25, P = 0.005) were major adverse cardiovascular events after PCI Independent predictors of events. Conclusions Carotid atherosclerosis has predictive value in the short-term prognosis of patients with premature coronary artery disease after interventional therapy. The incidence of major adverse cardiovascular events in patients with premature coronary artery disease with carotid atherosclerosis after interventional therapy is increased.