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目的回顾性分析冠心病合并代谢综合征(MS)患者的远期预后。方法对1995年10月～2002年12月,经冠状动脉造影证实冠心病的458例住院患者进行了随访。按美国国家胆固醇教育计划成人治疗组第三次报告的修改标准,分为合并MS(MS+)和不合并MS(MS-)两组。随访患者的治疗经过和心脑血管事件的发生情况。采用KaplanMeier法分别计算两组患者的生存率和无心脑血管事件生存率。结果458例患者随访20～108月(中位时间52.5月),冠心病合并MS的发生率为45.41%。MS+组患者的腰围、体重指数、空腹血糖、收缩压、舒张压、甘油三酯、尿酸和肌酐均显著高于MS-组患者,而高密度脂蛋白胆固醇显著低于MS-组患者。MS+患者得到更多的调脂和降压治疗。两组心脑血管事件的发生率相似。随访期间,两组的总生存率和无心脑血管事件生存率无显著差异。结论通过积极的综合干预,合并与不合并MS冠心病患者的远期预后相似。
Objective To retrospectively analyze the long-term prognosis of patients with coronary heart disease complicated with metabolic syndrome (MS). Methods From October 1995 to December 2002, 458 inpatients with coronary heart disease confirmed by coronary angiography were followed up. According to the revised standards of the third report of the American National Cholesterol Education Program adult treatment group, there are two groups: merged MS (MS +) and non-merged MS (MS-). Follow-up of patients after treatment and cardiovascular events. The KaplanMeier method was used to calculate the survival rate and no cardio-cerebral vascular event survival rate of the two groups. Results 458 patients were followed up for 20 to 108 months (median 52.5 months). The incidence of coronary heart disease with MS was 45.41%. Body mass index, fasting blood glucose, systolic blood pressure, diastolic blood pressure, triglyceride, uric acid and creatinine in MS + group were significantly higher than those in MS-group, while HDL cholesterol was significantly lower than that in MS-group. MS + patients receive more lipid-lowering and antihypertensive treatment. The incidence of cardiovascular and cerebrovascular events in both groups was similar. During the follow-up period, there was no significant difference in overall survival rate and no cardiovascular event-free survival between the two groups. Conclusions The long-term prognosis of patients with coronary heart disease without merger is similar to that of patients without coronary artery disease through aggressive intervention.