摘要:
目的 分析影响经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）术后死亡的危险因素。方法 选取2006年1月1日~2011年6月30日初次在北京大学人民医院、北京东直门中医院、沧州市中心医院和洛阳市中心医院4家医院接受PCI治疗并置入药物洗脱支架的冠心病患者为研究对象，对其术后死亡率以及影响死亡率的相关因素进行分析。结果 共随访患者3 511人（85.4%），PCI术后死亡率是4.6%（161/3 511），多因素分析结果显示：年龄（HR=1.086，95%CI：1.059~1.113，P<0.001）、糖尿病（HR=1.807，95%CI：1.205~2.709，P=0.004）、吸烟（HR=1.873，95%CI：1.205~2.709，P=0.002）、贫血（HR=1.909，95%CI：1.266~2.879，P=0.002）、左心射血分数<50%（HR=2.546，95%CI：1.558~4.162，P<0.001）和双联抗血小板治疗（dual antiplatelet therapy，DAPT）时间<1年（HR=0.029，95%CI：0.013~0.067，P<0.001）与患者PCI术后死亡率相关。结论 年龄、糖尿病、吸烟、贫血、心功能不良和DAPT时间<1年是影响冠心病患者PCI术后死亡率的危险因素，应该给予重视和合理干预。
Abstract:
Objective To discuss the risk factors of mortality after percutaneous coronary intervention (PCI) in patients with coronary heart disease. Methods A retrospective study was conducted among patients with coronary heart disease undergoing PCI with drug-eluting stents at four hospitals in China (Peking University People's Hospital; Beijing University of Chinese Medicine Dongzhimen Hospital; Cangzhou Central Hospital, Hebei Province; Luoyang Central Hospital, Henan Province) from January 1st, 2006 to June 30th, 2011. Multivariable cox proportional hazards models were used for analysis of mortality after PCI. Results 3 511 (85.4%) patients finished follow-up and the mortality after PCI was 4.6% (161/3 511). Age (HR=1.086, 95% CI:1.059-1.113, P<0.001), diabetes (HR=1.807, 95% CI:1.205-2.709, P=0.004), smoking (HR=1.873, 95% CI:1.205-2.709, P=0.002), anemia (HR=1.909, 95% CI:1.266-2.879,P=0.002), left ventricular ejection fraction <50% (HR=2.546, 95% CI:1.558-4.162, P<0.001) and dual antiplatelet therapy (DAPT) time less than one year (HR=0.029, 95% CI:0.013-0.067, P<0.001) were associated with increased all-cause mortality in patients undergoing PCI. Conclusions Age, diabetes, smoking, anemia, heart dysfunction and DAPT time less than one year were risk factors of mortality after PCI and it should be taken into account seriously and intervened properly.
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