摘要
目的:探讨急性冠脉综合征(acute coronary syndrome,ACS)患者发生冠脉血管完全闭塞病变的影响因素。方法:从2013年在我院诊断为ACS且行冠状动脉造影检查患者中随机筛选出120例患者为研究对象,记录其基线及临床资料,回顾其造影图像,计算SYNTAX积分,根据是否存在完全闭塞病变分组,分析慢性完全闭塞病变的影响因素。结果:与不完全闭塞病变组相比,完全闭塞病变组吸烟(61.1%,P=0.041)、糖尿病(35.2%,P=0.025)、高脂血症(55.6%,P=0.033)发生率高,入院静息心率(77.07±11.99,P=0.023)高,中性粒细胞/淋巴细胞比值(Neutrophil-to-Lymphocyte Ratio,NLR)水平(8.69±9.46,P<0.001)显著升高,左室射血分数(left ventricular ejection fraction,LVEF)(50.39±8.36,P=0.001)显著降低。多因素分析显示年龄(P=0.043)、急性心梗(acute myocardial infarction,AMI)的发生(P=0.003)、LVEF(P=0.002)、NLR(P=0.002)、脂蛋白(a)(P=0.039)、SYNTAX积分(P=0.002)和完全闭塞病变独立正相关。结论:ACS患者发生慢性完全闭塞病变与年龄、静息心率、吸烟史、高脂血症相关,与冠脉病变复杂程度、左室功能下降密切相关。NLR作为新型炎症标志之一,可预测ACS患者完全闭塞病变。
Objective： To explore the influencing factors of totally occluded lesion in coronary artery in acute coronary syndrome.Methods： One hundred and twenty patients from the cardiology intervention treatment center of General Hospital of Chinese People＇s Liberation Army who were diagnosed with acute coronary syndrome（ACS） and underwent coronary angiography were randomly selected as objects of study. The clinical data was obtained from the medical records. Reviewed the angiographic images and calculated the SYNTAX score. Divided the cases into two groups according to the existence of totally occluded lesion, then analysed the influencing factors of chronic total occlusion of coronary artery. Results： Compared with non-totally occluded lesion group, there existed high incidence of smoking（61.1 %, P=0.041）, diabetes（35.2 %, P=0.025） and hyperlipidemia（55.6 %, P=0.033） in the totally occluded lesion group, but also resting heart rate in hospital（7.07±11.99, P=0.023） and NLR levels（8.69±9.46, P0.001） were significantly higher in the totally occluded lesion group; whereas LVEF（50.39±8.36, P=0.001） decreased significantly. In the multivariable regression analysis, there was a positive correlation among age（P=0.043）, acute myocardial infarction（AMI）（P=0.003）, LVEF（P=0.002）, NLR（P=0.002）, Lipoprotein（a）（P=0.039）, SYNTAX SCORE（P=0.002） and chronic total occlusion. Conclusion： In patients with ACS, chronic total occlusion is closely related with age, resting heart rate, smoking and hyperlipidemia, as well as complexity of coronary artery lesions, decreased left ventricular function. As a new type of the inflammation biomarkers, NLR may predict chronic total occlusion in acute coronary syndrome.
出处
《现代生物医学进展》
CAS
2016年第7期1272-1275,共4页
Progress in Modern Biomedicine
基金
北京市自然科学基金项目(11BJZ19)
