血清胱抑素 C 与 ACS 患者 PCI 术后主要不良心血管事件的关系

摘要

目的 观察ACS患者PCI术后主要不良心血管事件(MACE)的发生率,探讨急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后发生MACE的影响因素.方法 对374例在我院接受PCI治疗的ACS患者的资料进行回顾性分析,采用Logistic多元回归分析ACS患者PCI术后1年内发生MACE的危险因素.结果 本研究374例患者,术后1年内发生MACE 86例,发生率22. 99%.多因素 Logistic回归分析显示年龄＞72.6岁、糖尿病、低密度脂蛋白‐胆固醇(LDL‐C)＞3.38mmol／L 、 CysC＞1.53mg／L是ACS患者PCI术后1年MACE发生的独立危险因素(OR＝1.550～4. 723 , P＜0. 05或＜0.01) ,围术期强化他汀治疗和围术期应用替罗非班是其保护性因素(OR＝0.672 、 0.596 , P均＝0. 001) .结论 急性冠脉综合征患者PCI术后MACE是多种因素协同作用的结果,术前CysC水平升高与患者PCI术后MACE发生密切相关,应引起临床重视.%To observe major adverse cardiovascular events (MACE) incidence rate in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) , and explore relationship between serum level of cystatin (Cys) C and incidence of MACE in ACS patients after PCI .Methods : Clinical data of 374 ACS pa‐tients undergoing PCI in our hospital were retrospectively analyzed .Multivariate Logistic regression was used to ana‐ lyze risk factors for MACE within one year after PCI in ACS patients .Results : Among the 374 patients , incidence rate of MACE within one year after PCI was 22.99% (86／374).Multivariate Logistic regression analysis indicated that age＞72.6 years , diabetes mellitus , low density lipoprotein cholesterol (LDL‐C)＞3.38 mmol／L and CysC＞1.53mg／L were independent risk factors for incidence of MACE within one year after PCI in ACS patients (OR＝1.550～4. 723 , P＜0. 05 or ＜0.01) , while perioperative intensive statin therapy and perioperative tirofiban appli‐cation were its independent protective factors (OR ＝ 0.672 , 0. 596 , P＝ 0. 001 both ).Conclusion : Incidence of MACE after PCI in ACS patients is a result caused by multiple factor synergy .Preoperative elevated CysC level is closely associated with incidence of MACE after PCI , which calls for clinical attention .