老年前降支单支病变冠心病病人经皮冠状动脉介入治疗术后运动耐量的影响因素分析

doi:10.3969/j.issn.1003-9198.2021.09.018

摘要/Abstract

摘要： 目的探讨老年前降支单支病变CHD病人经皮冠状动脉介入治疗(PCI)术后运动耐量的影响因素。方法回顾性分析2018年5月至2019年11月本院收治的126例老年前降支单支病变CHD病人的临床资料,根据病人PCI术后运动耐量将其分为运动耐量降低组与运动耐量正常组。采用多因素Logistic回归分析影响病人PCI术后运动耐量的因素。术后随访1年,比较2组主要不良心血管事件发生情况。结果老年前降支单支病变CHD病人运动耐量降低发生率为54.76%(69/126)。运动耐量降低组的LVEF、术后峰值摄氧量(VO_2peak)显著低于运动耐量正常组(P＜0.05),BMI、心率、左心房前后径(LAAD)、N末端B型脑钠肽前体(NT-proBNP)水平显著高于运动耐量正常组(P＜0.05),合并糖尿病、心肌梗死史及围术期发生心肌损伤的比例显著高于运动耐量正常组(P＜0.05)。多因素Logistic回归分析表明,合并糖尿病、心肌梗死史、围术期发生心肌损伤及VO_2peak均是老年前降支单支病变CHD病人PCI术后运动耐量的独立影响因素。PCI术后1年,2组病人主要不良心血管事件总发生率比较,差异无统计学意义(P＞0.05)。结论合并糖尿病、心肌梗死史、围术期发生心肌损伤及VO_2peak均是老年前降支单支病变CHD病人PCI术后运动耐量独立的影响因素,临床中需对以上因素注意加强防范。

关键词: 老年人;冠心病, 经皮冠状动脉介入治疗, 运动耐量, 影响因素

Abstract: Objective To investigate the influencing factors of exercise tolerance in the elderly patients with single vessel lesion of anterior descending coronary artery after percutaneous coronary intervention (PCI). Methods The clinical data of 126 elderly patients with single vessel lesion of anterior descending coronary artery in our hospital from May 2018 to November 2019 were retrospectively analyzed. According to the exercise tolerance after PCI,the patients were divided into the exercise tolerance decreased group and the exercise tolerance normal group. The influencing factors of exercise tolerance in the elderly patients with single vessel lesion of anterior descending coronary artery after PCI were analyzed by multivariate Logistic regression analysis. The patients were followed up for 1 year after PCI, and the incidence rate rate of major adverse cardiovascular events was compared between the two groups. Results The incidence rate of reduced exercise tolerance in the elderly patients with single vessel lesion of anterior descending coronary artery after PCI was 54.76% (69/126).Compared with the normal exercise tolerance group, the levels of left ventricular ejection fraction (LVEF) and peak oxygen uptake (VO_2peak) in the reduced exercise tolerance group decreased, the levels of body mass index (BMI), heart rate, left atrial anteroposterior diameter (LAAD) and N-terminal B-type pro-brain natriuretic peptide (NT-proBNP) in the exercise tolerance group increased. And the composition ratios of diabetes, history of myocardial infarction, and perioperative myocardial injury in the exercise tolerance decreased group were significantly higher than those in the normal exercise tolerance group (P＜0.05). Multivariate Logistic regression analysis showed that combined with diabetes, history of myocardial infarction, perioperative myocardial injury and VO_2peakwere independent influencing factors of exercise tolerance in the elderly patients with single vessel lesion of anterior descending coronary artery after PCI. One year after PCT, there was no significant difference in the total incidence of major adverse cardiovascular events between the two groups (P>0.05). Conclusions Diabetes mellitus, history of myocardial infarction, perioperative myocardial injury and VO₂_peak are influencing factors of exercise tolerance in the elderly patients with single vessel lesion of anterior descending coronary artery after PCI.

Key words: aged, coronary heart disease, percutaneous coronary intervention, exercise tolerance, influencing factor

中图分类号:

R 541.4

刘洪强, 张洪磊, 郑晓辉. 老年前降支单支病变冠心病病人经皮冠状动脉介入治疗术后运动耐量的影响因素分析[J]. 实用老年医学, 2021, 35(9): 967-970.

LIU Hong-qiang, ZHANG Hong-lei, ZHENG Xiao-hui. Influencing factors of exercise tolerance in elderly patients with single vessel lesion of anterior descending coronary artery after percutaneous coronary intervention[J]. Practical Geriatrics, 2021, 35(9): 967-970.

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