摘要
目的:探讨退行性心脏瓣膜病患者合并冠心病的高危因素,探寻提高退行性心脏瓣膜病围术期冠状动脉(冠脉)造影选择性的方法。方法:回顾性分析2013-01-2017-06我院173例退行性心脏瓣膜病手术患者的临床资料,术前均行冠脉造影(CAG)检查。按是否同期诊断冠脉病变分为冠脉病变组和无冠脉病变组,比较两组患者的临床资料,采用单因素和多因素Logistic回归分析退行性心脏瓣膜病合并冠脉病变的危险因素及临床疗效的差别。结果:CAG结果显示,39例合并冠心病,发生率为22.5%,其中24例同期行冠脉旁路移植术。统计分析表明冠脉病变发生与心脏瓣膜疾病类型之间无明显关联(χ~2=4.045,P=0.132);而年龄≥55岁(OR=4.779,P=0.001)、有典型胸痛症状(OR=102.218,P=0.001)、合并糖尿病(OR=7.436,P=0.016)则是退行性心脏瓣膜病患者合并冠脉病变的独立危险因素。结论:对于年龄≥55岁、有典型胸痛和合并糖尿病的退行性心脏瓣膜病患者术前行CAG检查具有明确的指征。
Objective:To investigate the high risk factors of degenerative valvular heart disease patients with coronary heart disease and to explore the method of improving the selectivity of perioperative coronary angiography in patients with degenerative heart valve disease.Method:During the period of 2013.01-2017.06,the clinical data of 173 patients with degenerative valvular heart disease who underwent valvular surgery were retrospectively analyzed.Preoperative coronary angiography(CAG) was carried out.According to whether the diagnosis of coronary lesion,the patients were divided into coronary artery disease group and no coronary artery disease group.The clinical data of the two groups was compared and statistical analysis was performed.Risk factors and clinical treatment effects of degenerative valvular heart disease with coronary lesion were analyzed by factors and logistic multivariate regression.Result:Coronary angiography results indicated that 39 patients had coronary lesion;the incidence rate was 22.5%,of which 24 patients underwent coronary artery bypass grafting(CABG).Statistical analysis showed that there are no significant association between the occurrence of coronary lesion and the type of degenerative valvular heart disease(χ~2=4.045,P=0.132);and age ≥55 years(OR=4.779,P=0.001),typical chest pain symptoms(OR=102.218,P=0.001),combined with diabetes(OR=7.436,P=0.016) were independent risk factors for coronary lesion in patients with degenerative valvular heart disease.Conclusion:Preoperative coronary angiography has a clearer indication for patients with degenerative valvular heart disease who is ≥55 years old with typical chest pain and diabetes.
作者
徐盛松
石开虎
XU Shengsong;SHI Kaihu(Department of Cardiothoracic Surgery,the Second Affiliated Hospital of Anhui Medical University,Hefei,230601,China)
出处
《临床心血管病杂志》
CAS
北大核心
2019年第4期310-313,共4页
Journal of Clinical Cardiology
基金
国家自然科学基金项目(No:81570295)
安徽省科技攻关项目(No:1501041148)
关键词
退行性心脏瓣膜病
冠心病
心脏外科手术治疗
冠状动脉造影
degenerative valvular heart disease
coronary atherosclerotic heart disease
cardiac surgery
coronary angiography
