摘要
目的探索高风险冠心病患者肺癌肺叶切除术的围术期心脏事件的发生率及危险因素。方法收集本院收治的1 647例肺癌患者的病例资料进行Framingham评分,将高风险冠心病患者(评分> 20%)纳入研究,以围术期主要心脏事件为终点,探索患者围术期心脏事件的相关影响因素。结果高风险冠心病肺癌患者围术期主要心血管不良事件(MACE)发生率为26. 4%。多因素回归分析显示,各因素对患者发生围术期心脏事件影响由大到小依次为:高血压>高密度脂蛋白胆固醇(HDL-C)>糖尿病>年龄>冠脉造影>脑卒中>吸烟指数。结论高风险冠心病肺癌患者围术期心脏事件发生率较高,充分的术前心脏风险评分、冠脉造影及干预有助于降低高风险冠心病患者肺癌围术期心脏事件的发生率。
Objective To explore the incidence and risk factors of perioperative major adverse cardiac events(MACE)in lung cancer patients with high-risk coronary heart disease undergoing pulmonary lobectomy.Methods The clinical dataof 1 647 high-risk coronary heart disease patients diagnosed with lung cancer undergoing lobectomy in our hospital was analyzed,and performed Framingham scoring.High-risk patients(score>20%)were included in the study,and the periopertive major adverse cardiac events was defined as primary endpoint.The risk factors of MACE were analyzed.Results Perioperative MACE occurred in 26.4%of lung cancer patients with high-risk coronary heart disease undergoing lobectomy.Multivariate analysis demonstrated that hypertension,high density lipoprotein(HDL-C),diabetes,age,coronary angiography,stroke,smoking index in descending sequence were independent risk factors of perioperative cardiac events in lung cancer patients.While shorter operative time,coronary angiography and clinical intervention was protective factor.Conclusion Lung cancer patients with high-risk coronary heart disease undergoing lobectomy has higher risk of perioperative MACE.Preoperative sufficient cardiac risk scores,coronary angiography andclinical interventioncan reduce the incidence of perioperative MACE in lung cancer patients with high-risk coronary heart disease.
作者
王川西
戴天阳
何开明
蒲江涛
曾培元
胡智
韩飞
WANG Chuanxi;DAI Tianyang;HE Kaiming;PU Jiangtao;ZENG Peiyuan;HU Zhi;HAN Fei(Department of Thoracic Surgery,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan,646000)
出处
《实用临床医药杂志》
CAS
2019年第7期44-49,共6页
Journal of Clinical Medicine in Practice
关键词
肺癌
冠心病
肺叶切除术
心血管不良事件
Framingham评分
高血压
高密度脂蛋白
冠脉造影
lung cancer
coronary heart disease
lobectomy
major adverse cardiovascular events
Framingham score
hypertension
high density lipoprotein
coronary angiography
