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目的探讨冠心病(CAD)患者经皮冠状动脉介入(PCI)治疗术后中是否存在“肥胖矛盾现象”。方法选择既往以肥胖作为危险因素,与CAD患者PCI术后全因死亡及心脏性死亡的队列研究,随访至少12个月。根据体重指数(BMI)将患者分为:低体重、正常体重、超重、肥胖及重度肥胖五组。结果检索到12个研究,入选患者24 585例,平均随访2.6年,BMI正常的CAD患者PCI术后总死亡率较肥胖组增加(OR=1.42,95%CI 1.27-1.58),而心脏源性死亡呈增加趋势(OR=1.21,95%CI 0.86-1.72)。结论合并肥胖的CAD患者PCI术后长期随访有着较低的全因死亡及心脏性死亡;患者PCI术后存在肥胖矛盾现象,提示应寻找能更准确的方法评价CAD患者机体脂肪过多的议题。
Objective To investigate whether “obesity contradiction” exists after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CAD). METHODS: A cohort study of obesity as a risk factor and all-cause and cardiac death after CAD in patients with CAD was followed up for at least 12 months. According to body mass index (BMI), patients were divided into five groups: low body weight, normal body weight, overweight, obesity and severe obesity. Results A total of 24 585 patients were retrieved in 12 studies. With a mean follow-up of 2.6 years, the overall mortality rate of PCI patients with normal BMI was higher than that of the obese patients (OR = 1.42, 95% CI 1.27-1.58) Death tended to increase (OR = 1.21, 95% CI 0.86-1.72). CONCLUSIONS: Long-term follow-up of patients with obese CAD after PCI is associated with a lower risk of all-cause and cardiac death. Obese contractions persist after PCI in patients with CAD, suggesting that more accurate methods should be sought to evaluate the topic of adiposity in CAD patients.