Chinese General Practice ›› 2022, Vol. 25 ›› Issue (27): 3365-3372.DOI: 10.12114/j.issn.1007-9572.2022.0206
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Received:
2022-02-10
Revised:
2022-04-28
Published:
2022-09-20
Online:
2022-07-07
Contact:
Lin CAI
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通讯作者:
蔡琳
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0206
组别 | 例数 | 性别〔n( %)〕 | 年龄( | 糖尿病史〔n( %)〕 | 高血压史〔n( %)〕 | 高脂血症史〔n( %)〕 | 高尿酸血症史〔n(%)〕 | 心房颤动史〔n( %)〕 | 冠心病史〔n( %)〕 | 心肌梗死史〔n( %)〕 | PCI手术史〔n( %)〕 | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
男 | 女 | |||||||||||
闭塞组 | 42 | 35(83.3) | 7(16.7) | 66.9±12.0 | 15(35.7) | 26(61.9) | 18(42.9) | 8(19.0) | 2(4.8) | 6(14.3) | 1(2.4) | 2(4.8) |
非闭塞组 | 265 | 182(68.7) | 83(31.3) | 67.2±10.5 | 88(33.2) | 175(66.0) | 144(54.3) | 44(16.6) | 18(6.8) | 65(24.5) | 11(4.2) | 15(5.7) |
检验统计量值 | 3.757b | -0.177a | 0.102b | 0.274b | 1.918b | 0.154b | — | 2.139b | — | — | ||
P值 | 0.053 | 0.860 | 0.749 | 0.601 | 0.166 | 0.695 | 1.000 | 0.144 | 1.000 | 1.000 | ||
组别 | 目前吸烟〔n( %)〕 | BMI〔 | 入院至行PCI时间〔M(P25,P75),d〕 | 入院时胸痛/胸闷〔n( %)〕 | 入院诊断〔n(%)〕 | 合并心源性休克 | 入院心电图情况〔n(%)〕 | 心率〔M(P25,P75),次/min〕 | ||||
NSTEMI | UA | 窦性心律 | ST段压低 | T波倒置 | ||||||||
闭塞组 | 13(31.0) | 24.1±2.5 | 3.0(1.8,6.0) | 35(83.3) | 26(61.9) | 16(38.1) | 2(4.8) | 22(52.4) | 15(35.7) | 10(23.8) | 79(68,85) | |
非闭塞组 | 91(34.5) | 24.6±3.1 | 3.5(2.0,6.0) | 227(85.7) | 98(37.0) | 167(63.0) | 2(0.8) | 158(60.3) | 76(29.0) | 50(19.1) | 75(67,84) | |
检验统计量值 | 0.200b | -0.792 | -0.591 | 0.157b | 9.354b | — | 0.941b | 0.776b | 0.510b | -0.839 | ||
P值 | 0.655 | 0.429 | 0.555 | 0.692 | 0.002 | 0.092 | 0.332 | 0.378 | 0.475 | 0.402 | ||
组别 | 收缩压〔M(P25,P75),mm Hg〕 | 舒张压〔M(P25,P75),mm Hg〕 | LVEF〔M(P25,P75),%〕 | 高敏肌钙蛋白T〔M(P25,P75),ng/L〕 | CK-MB〔M(P25,P75),μg/L〕 | BNP〔M(P25,P75),ng/L〕 | 血肌酐〔M(P25,P75),μmol/L〕 | |||||
闭塞组 | 127(116,136) | 76(67,81) | 55.00(50.00,59.00) | 122.60(31.77,1 033.00) | 3.39(1.52,10.46) | 187.20(80.58,365.65) | 81.45(66.35,93.65) | |||||
非闭塞组 | 132(121,146) | 77(70,86) | 60.00(56.00,63.00) | 17.87(8.71,119.28) | 1.81(1.24,3.59) | 77.40(29.00,191.20) | 75.10(63.55,88.55) | |||||
检验统计量值 | -2.457 | -1.013 | -3.391 | -4.018 | -2.819 | -3.639 | -1.561 | |||||
P值 | 0.014 | 0.311 | 0.001 | <0.001 | 0.005 | <0.001 | 0.119 | |||||
组别 | 血清肌酐清除率〔M(P25,P75),ml/min〕 | 血糖〔M(P25,P75),mmol/L〕 | 三酰甘油〔M(P25,P75),mmol/L〕 | 总胆固醇〔M(P25,P75),mmol/L〕 | LDL-C〔M(P25,P75),mmol/L〕 | HDL-C〔M(P25,P75),mmol/L〕 | 丙氨酸氨基转移酶〔M(P25,P75),U/L〕 | 天冬氨酸氨基转移酶〔M(P25,P75),U/L〕 | ||||
闭塞组 | 71.55(56.33,77.88) | 5.52(4.83,7.41) | 1.67(1.15,2.31) | 4.42(3.94,5.15) | 2.73(2.35,3.37) | 1.10(0.97,1.35) | 25.70(18.85,36.80) | 31.00(21.80,53.85) | ||||
非闭塞组 | 73.00(60.10,82.70) | 5.56(4.94,7.17) | 1.43(1.10,2.22) | 4.32(3.63,5.12) | 2.62(2.15,3.26) | 1.13(0.96,1.29) | 21.10(15.40,32.20) | 23.60(19.40,35.70) | ||||
检验统计量值 | -1.159 | -0.242 | -1.264 | -0.705 | -1.174 | -0.223 | -1.895 | -2.623 | ||||
P值 | 0.247 | 0.809 | 0.206 | 0.481 | 0.240 | 0.824 | 0.058 | 0.009 | ||||
组别 | 罪犯血管部位〔n(%)〕 | 多支血管病变〔n( %)〕 | 并发CTO〔n( %)〕 | 术后罪犯血管TIMI血流3级〔n( %)〕 | 出院带药〔n(%)〕 | |||||||
左前降支冠状动脉 | 左回旋支冠状动脉 | 右冠状动脉 | 其他冠状动脉 | 双联抗血小板药物 | 降脂药物 | β-受体阻滞剂 | ACEI/ARB | 钙通道阻滞剂 | ||||
闭塞组 | 14(33.3) | 13(31.0) | 15(35.7) | 0 | 26(61.9) | 8(19.0) | 40(95.2) | 40(95.2) | 42(100) | 32(76.2) | 18(42.9) | 10(23.8) |
非闭塞组 | 149(56.2) | 43(16.2) | 71(26.8) | 2(0.8) | 124(46.8) | 23(8.7) | 263(99.2) | 260(98.1) | 254(95.8) | 179(67.5) | 123(46.4) | 84(31.7) |
检验统计量值 | 7.629b | 5.272b | 1.431b | — | 3.314b | — | — | — | — | 1.260b | 0.185b | 1.062b |
P值 | 0.006 | 0.022 | 0.232 | 1.000 | 0.069 | 0.051 | 0.092 | 0.246 | 0.372 | 0.262 | 0.667 | 0.303 |
Table 1 Comparison of clinical data of non-ST-segment elevation acute coronary syndrome patients with and without total occlusion of the culprit artery
组别 | 例数 | 性别〔n( %)〕 | 年龄( | 糖尿病史〔n( %)〕 | 高血压史〔n( %)〕 | 高脂血症史〔n( %)〕 | 高尿酸血症史〔n(%)〕 | 心房颤动史〔n( %)〕 | 冠心病史〔n( %)〕 | 心肌梗死史〔n( %)〕 | PCI手术史〔n( %)〕 | |
---|---|---|---|---|---|---|---|---|---|---|---|---|
男 | 女 | |||||||||||
闭塞组 | 42 | 35(83.3) | 7(16.7) | 66.9±12.0 | 15(35.7) | 26(61.9) | 18(42.9) | 8(19.0) | 2(4.8) | 6(14.3) | 1(2.4) | 2(4.8) |
非闭塞组 | 265 | 182(68.7) | 83(31.3) | 67.2±10.5 | 88(33.2) | 175(66.0) | 144(54.3) | 44(16.6) | 18(6.8) | 65(24.5) | 11(4.2) | 15(5.7) |
检验统计量值 | 3.757b | -0.177a | 0.102b | 0.274b | 1.918b | 0.154b | — | 2.139b | — | — | ||
P值 | 0.053 | 0.860 | 0.749 | 0.601 | 0.166 | 0.695 | 1.000 | 0.144 | 1.000 | 1.000 | ||
组别 | 目前吸烟〔n( %)〕 | BMI〔 | 入院至行PCI时间〔M(P25,P75),d〕 | 入院时胸痛/胸闷〔n( %)〕 | 入院诊断〔n(%)〕 | 合并心源性休克 | 入院心电图情况〔n(%)〕 | 心率〔M(P25,P75),次/min〕 | ||||
NSTEMI | UA | 窦性心律 | ST段压低 | T波倒置 | ||||||||
闭塞组 | 13(31.0) | 24.1±2.5 | 3.0(1.8,6.0) | 35(83.3) | 26(61.9) | 16(38.1) | 2(4.8) | 22(52.4) | 15(35.7) | 10(23.8) | 79(68,85) | |
非闭塞组 | 91(34.5) | 24.6±3.1 | 3.5(2.0,6.0) | 227(85.7) | 98(37.0) | 167(63.0) | 2(0.8) | 158(60.3) | 76(29.0) | 50(19.1) | 75(67,84) | |
检验统计量值 | 0.200b | -0.792 | -0.591 | 0.157b | 9.354b | — | 0.941b | 0.776b | 0.510b | -0.839 | ||
P值 | 0.655 | 0.429 | 0.555 | 0.692 | 0.002 | 0.092 | 0.332 | 0.378 | 0.475 | 0.402 | ||
组别 | 收缩压〔M(P25,P75),mm Hg〕 | 舒张压〔M(P25,P75),mm Hg〕 | LVEF〔M(P25,P75),%〕 | 高敏肌钙蛋白T〔M(P25,P75),ng/L〕 | CK-MB〔M(P25,P75),μg/L〕 | BNP〔M(P25,P75),ng/L〕 | 血肌酐〔M(P25,P75),μmol/L〕 | |||||
闭塞组 | 127(116,136) | 76(67,81) | 55.00(50.00,59.00) | 122.60(31.77,1 033.00) | 3.39(1.52,10.46) | 187.20(80.58,365.65) | 81.45(66.35,93.65) | |||||
非闭塞组 | 132(121,146) | 77(70,86) | 60.00(56.00,63.00) | 17.87(8.71,119.28) | 1.81(1.24,3.59) | 77.40(29.00,191.20) | 75.10(63.55,88.55) | |||||
检验统计量值 | -2.457 | -1.013 | -3.391 | -4.018 | -2.819 | -3.639 | -1.561 | |||||
P值 | 0.014 | 0.311 | 0.001 | <0.001 | 0.005 | <0.001 | 0.119 | |||||
组别 | 血清肌酐清除率〔M(P25,P75),ml/min〕 | 血糖〔M(P25,P75),mmol/L〕 | 三酰甘油〔M(P25,P75),mmol/L〕 | 总胆固醇〔M(P25,P75),mmol/L〕 | LDL-C〔M(P25,P75),mmol/L〕 | HDL-C〔M(P25,P75),mmol/L〕 | 丙氨酸氨基转移酶〔M(P25,P75),U/L〕 | 天冬氨酸氨基转移酶〔M(P25,P75),U/L〕 | ||||
闭塞组 | 71.55(56.33,77.88) | 5.52(4.83,7.41) | 1.67(1.15,2.31) | 4.42(3.94,5.15) | 2.73(2.35,3.37) | 1.10(0.97,1.35) | 25.70(18.85,36.80) | 31.00(21.80,53.85) | ||||
非闭塞组 | 73.00(60.10,82.70) | 5.56(4.94,7.17) | 1.43(1.10,2.22) | 4.32(3.63,5.12) | 2.62(2.15,3.26) | 1.13(0.96,1.29) | 21.10(15.40,32.20) | 23.60(19.40,35.70) | ||||
检验统计量值 | -1.159 | -0.242 | -1.264 | -0.705 | -1.174 | -0.223 | -1.895 | -2.623 | ||||
P值 | 0.247 | 0.809 | 0.206 | 0.481 | 0.240 | 0.824 | 0.058 | 0.009 | ||||
组别 | 罪犯血管部位〔n(%)〕 | 多支血管病变〔n( %)〕 | 并发CTO〔n( %)〕 | 术后罪犯血管TIMI血流3级〔n( %)〕 | 出院带药〔n(%)〕 | |||||||
左前降支冠状动脉 | 左回旋支冠状动脉 | 右冠状动脉 | 其他冠状动脉 | 双联抗血小板药物 | 降脂药物 | β-受体阻滞剂 | ACEI/ARB | 钙通道阻滞剂 | ||||
闭塞组 | 14(33.3) | 13(31.0) | 15(35.7) | 0 | 26(61.9) | 8(19.0) | 40(95.2) | 40(95.2) | 42(100) | 32(76.2) | 18(42.9) | 10(23.8) |
非闭塞组 | 149(56.2) | 43(16.2) | 71(26.8) | 2(0.8) | 124(46.8) | 23(8.7) | 263(99.2) | 260(98.1) | 254(95.8) | 179(67.5) | 123(46.4) | 84(31.7) |
检验统计量值 | 7.629b | 5.272b | 1.431b | — | 3.314b | — | — | — | — | 1.260b | 0.185b | 1.062b |
P值 | 0.006 | 0.022 | 0.232 | 1.000 | 0.069 | 0.051 | 0.092 | 0.246 | 0.372 | 0.262 | 0.667 | 0.303 |
变量 | 单因素Logistic | 多因素Logistic | ||||
---|---|---|---|---|---|---|
OR值 | 95%CI | P值 | OR值 | 95%CI | P值 | |
男性 | 0.439 | (0.187,1.028) | 0.058 | 0.519 | (0.189,1.430) | 0.205 |
年龄 | 0.997 | (0.967,1.028) | 0.859 | 1.013 | (0.978,1.050) | 0.462 |
收缩压 | 0.974 | (0.956,0.992) | 0.005 | 0.982 | (0.962,1.002) | 0.079 |
LVEF×(-1) | 1.066 | (1.025,1.109) | 0.001 | 1.064 | (1.018,1.112) | 0.006 |
高敏肌钙蛋白T | 1.000 | (1.000,1.000) | 0.646 | 1.000 | (1.000,1.000) | 0.665 |
Table 2 Univariate and multivariate Logistic regression analyses of related factors for total occlusion of the culprit artery in patients with non-ST-segment elevation acute coronary syndrome
变量 | 单因素Logistic | 多因素Logistic | ||||
---|---|---|---|---|---|---|
OR值 | 95%CI | P值 | OR值 | 95%CI | P值 | |
男性 | 0.439 | (0.187,1.028) | 0.058 | 0.519 | (0.189,1.430) | 0.205 |
年龄 | 0.997 | (0.967,1.028) | 0.859 | 1.013 | (0.978,1.050) | 0.462 |
收缩压 | 0.974 | (0.956,0.992) | 0.005 | 0.982 | (0.962,1.002) | 0.079 |
LVEF×(-1) | 1.066 | (1.025,1.109) | 0.001 | 1.064 | (1.018,1.112) | 0.006 |
高敏肌钙蛋白T | 1.000 | (1.000,1.000) | 0.646 | 1.000 | (1.000,1.000) | 0.665 |
临床事件 | HR值 | 95%CI | P值 | |
---|---|---|---|---|
MACCE | ||||
罪犯血管闭塞 | 2.684 | (1.229,5.862) | 0.013 | |
全因死亡 | ||||
罪犯血管闭塞 | 0.890 | (0.154,5.125) | 0.896 | |
新发脑卒中 | ||||
罪犯血管闭塞 | 4.904 | (0.615,39.090) | 0.133 | |
再发心肌梗死 | ||||
罪犯血管闭塞 | 1.463 | (0.166,12.873) | 0.732 | |
再次血运重建 | ||||
罪犯血管闭塞 | 3.024 | (1.320,6.931) | 0.009 |
Table 3 Multivariate Cox regression analysis of related factors for MACCE in patients with non-ST-segment elevation acute coronary syndrome
临床事件 | HR值 | 95%CI | P值 | |
---|---|---|---|---|
MACCE | ||||
罪犯血管闭塞 | 2.684 | (1.229,5.862) | 0.013 | |
全因死亡 | ||||
罪犯血管闭塞 | 0.890 | (0.154,5.125) | 0.896 | |
新发脑卒中 | ||||
罪犯血管闭塞 | 4.904 | (0.615,39.090) | 0.133 | |
再发心肌梗死 | ||||
罪犯血管闭塞 | 1.463 | (0.166,12.873) | 0.732 | |
再次血运重建 | ||||
罪犯血管闭塞 | 3.024 | (1.320,6.931) | 0.009 |
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