老年急性ST段抬高型心肌梗死病人营养不良风险与PCI术后预后的关系

doi:10.3969/j.issn.1003-9198.2025.05.010

摘要/Abstract

摘要： 目的探讨老年急性ST段抬高型心肌梗死(STEMI)病人营养状态及其与经皮冠状动脉介入术(PCI)后主要不良心血管事件(MACEs)的关系。方法连续纳入2018—2021年接受急诊PCI治疗的老年STEMI病人361例。应用营养风险筛查2002(NRS-2002)量表评估病人术后营养状态(NRS-2002≥3分定义为有营养不良风险)并随访1年,主要研究终点为MACEs(全因死亡、再发心肌梗死、支架内血栓形成和非计划再次血运重建的复合终点)发生,采用Cox回归分析MACEs的影响因素。结果 361例病人中,NRS-2002≥3分者共108例(29.92%)。随访1年,失访21例(5.82%),共66例病人发生MACEs(66/340,19.41%)。相较于NRS-2002<3分的病人,NRS-2002≥3分的老年STEMI病人PCI术后MACEs发生率更高(P＜0.001)。多因素Cox比例风险分析显示,NRS-2002≥3分是老年STEMI病人PCI术后发生MACEs的独立危险因素(OR=2.868, 95%CI:1.395~5.897,P=0.004)。结论老年STEMI病人需重视营养不良问题,NRS-2002≥3分是老年STEMI病人PCI术后预后不良的独立危险因素。

关键词: ST段抬高型心肌梗死, 营养风险筛查2002, 老年人, 预后, 经皮冠状动脉介入术

Abstract: Objective To investigate the status of nutrition and its relationship with major adverse cardiovascular events (MACEs) in the elderly patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI). Methods A total of 361 elderly patients with STEMI who underwent emergency PCI from 2018 to 2021 were consecutively enrolled. Nutritional Risk Screening 2002 (NRS-2002) was used to evaluate the risk of malnutrition (NRS-2002 ≥3 was defined as being at risk of malnutritional). The main study endpoint was the occurrence of MACEs within one year of follow-up,including all-cause death, recurrent myocardial infarction, stent thrombosis, and unplanned repeat revascularization. Cox regression analysis was used to investigate the influencing factors of MACEs. Results Among 361 patients, 108 patients (29.92%) had an NRS-2002 score of ≥3. After one year of follow-up, 21 cases (5.82%) were lost to follow-up, and a total of 66 patients presented with MACEs (66/340, 19.41%). The elderly STEMI patients with NRS-2002≥3 were more prone to MACEs than those with NRS-2002<3 (P<0.001). Multivariate Cox proportional hazards analysis showed that NRS-2002≥3 is an independent risk factor for MACEs in the elderly STEMI patients who underwent PCI (OR=2.868, 95%CI: 1.395-5.897, P=0.004). Conclusions The elderly patients with STEMI should pay attention to malnutrition.NRS-2002≥3 is an independent risk factor for poor prognosis in the elderly STEMI patients who underwent PCI.

Key words: ST-segment elevation myocardial infarction, Nutritional Risk Screening-2002, aged, prognosis, percutaneous coronary intervention

中图分类号:

R 542.2

王国余, 许岑, 王健, 王如珠. 老年急性ST段抬高型心肌梗死病人营养不良风险与PCI术后预后的关系[J]. 实用老年医学, 2025, 39(5): 482-486.

WANG Guoyu, XU Cen, WANG Jian, WANG Ruzhu. Relationship between the risk of malnutritional and prognosis in elderly patients with acute ST-segment elevation myocardial infarction who underwent percutaneous coronary intervention[J]. Practical Geriatrics, 2025, 39(5): 482-486.

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