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目的探讨非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者经皮冠状动脉介入治疗(PCI)现状及影响因素。方法收集2008年1月至2015年12月洛阳市中心医院出院诊断为NSTE-ACS患者的临床资料,包括性别、年龄、吸烟、饮酒、高血压病、2型糖尿病、陈旧性脑梗死、慢性肾脏病、陈旧性心肌梗死,血糖、血脂、肌酐、心肌标记物,冠状动脉造影及介入治疗情况等,共收集475例NSTE-ACS患者。其中214例接受冠状动脉造影术,分为PCI组(n=109)与非PCI组(n=105),比较两组间一般资料,多因素Logistic回归分析冠状动脉介入治疗的影响因素。结果 PCI组(n=109)与非PCI组(n=105)相比,男性(67.0%vs 51.4%,P<0.01)、非ST段抬高型心肌梗死(NSTE-MI)(32.1%vs 9.5%,P<0.01)、心功能Ⅱ级(50.9%vs 30.4%,P<0.01)比例较高,空腹血糖水平(6.5±2.6mmol/L vs 5.8±1.9mmol/L,P=0.02)偏高。两组吸烟、饮酒、高血压病等心血管危险因素、肌酐、血脂水平差异无统计学意义。多因素Logistic回归分析显示男性、心功能Ⅱ级、NSTE-MI是PCI治疗的支持因素。结论本中心NSTE-ACS患者冠状动脉介入治疗率为22.9%,男性、心功能Ⅱ级、NSTE-MI是介入治疗的支持因素。
Objective To investigate the status and influencing factors of percutaneous coronary intervention (PCI) in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). Methods The clinical data of patients with NSTE-ACS diagnosed as discharged from Luoyang Central Hospital from January 2008 to December 2015 were collected, including gender, age, smoking, drinking, hypertension, type 2 diabetes mellitus, old cerebral infarction, chronic kidney A total of 475 patients with NSTE-ACS were enrolled in the study, including the disease, old myocardial infarction, blood glucose, blood lipid, creatinine, myocardial markers, coronary angiography and interventional treatment. Two hundred and seventy-two patients underwent coronary angiography and were divided into PCI group (n = 109) and non-PCI group (n = 105). The general data were compared between the two groups. Multivariate logistic regression analysis was used to analyze the influencing factors of coronary intervention. Results Compared with non-PCI group (n = 109), the incidence of non-ST-elevation myocardial infarction (NSTE-MI) was significantly higher in the PCI group (67.0% vs 51.4%, P <0.01) (P <0.01). The level of cardiac function in grade Ⅱ (50.9% vs 30.4%, P <0.01) was higher than the control group high. There was no significant difference in cardiovascular risk factors, creatinine and blood lipid between the two groups in terms of smoking, drinking, hypertension and so on. Multivariate logistic regression analysis showed that male, cardiac function grade II, and NSTE-MI were the supporting factors for PCI. Conclusion The intervention rate of coronary intervention in NSTE-ACS patients in our center is 22.9%. Male, grade Ⅱ heart function and NSTE-MI are the supporting factors for interventional therapy.