【摘要】：目的探討冠心病患者血管重建后吸煙狀態(tài)對(duì)其長期臨床預(yù)后的影響。方法將893例冠心病患者根據(jù)血管重建術(shù)前及術(shù)后的吸煙狀態(tài)分為3組:不吸煙組(n=458)、戒煙組(n=287)及吸煙組(n=148),詳細(xì)記錄隨訪時(shí)主要不良心腦血管事件(MACCE)的發(fā)生情況。Kaplan-Meier生存分析描述術(shù)后累計(jì)生存率,并比較吸煙狀態(tài)對(duì)全因性死亡及MACCE的影響,Cox多元逐步回歸分析全因性死亡及MACCE的影響因素。結(jié)果平均隨訪時(shí)間約為27個(gè)月,術(shù)后吸煙率較術(shù)前吸煙率明顯降低(16.57%vs.48.71%),且吸煙組患者較年輕(P0.01);不吸煙組患者多為女性(P0.01),體質(zhì)量指數(shù)(BMI)較小(P0.01)。吸煙組全因性死亡(1.53%vs.1.05%vs.6.76%,P=0.002)和MACCE(4.37%vs.5.23%vs.15.54%,P=0.001)的發(fā)生率較高,Cox多元逐步回歸分析顯示,術(shù)后持續(xù)吸煙是導(dǎo)致全因性死亡[HR=2.753,95%CI(1.695~4.473),P0.01]和MACCE[HR=1.552,95%CI(1.049~1.754),P=0.001]發(fā)生的重要危險(xiǎn)因素。結(jié)論冠心病患者血管重建后持續(xù)吸煙是導(dǎo)致術(shù)后發(fā)生全因性死亡和MACCE的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to investigate the effect of smoking status on long-term clinical prognosis in patients with coronary heart disease (CHD) after revascularization. Methods according to the smoking status before and after revascularization, 893 patients with coronary heart disease were divided into 3 groups: non smoking group (nnf458), smoking cessation group (nnf287) and smoking group (nnf148). The incidence of major adverse cardiovascular and cerebrovascular events (MACCE) during follow-up was recorded in detail. The cumulative survival rate was described by survival analysis. The effects of smoking status on all-cause death and MACCE were compared. Multivariate Cox stepwise regression analysis was used to analyze the influencing factors of all-cause death and MACCE. Results the average follow-up time was about 27 months. The smoking rate after operation was significantly lower than that before operation (16.57 vs 48.71%), and the smoking group was younger (P0.01), the non-smoking group was mostly female (P0.01), and the body mass index (BMI) was smaller (P0.01). The incidence of all-cause death (1.53v s.1.05vs.6.76P0.002) and MACCE (4.37vs.5.23vs.15.54P0.001) in smoking group was higher than that in smoking group. Cox stepwise regression analysis showed that continuous smoking after operation was an important risk factor for overall death [HR2.75395CI (1.6955.473) P0.01] and MACCE [1.55295CI (1.0491.754) P0.001]. Conclusion continuous smoking after revascularization is an independent risk factor for postoperative all-cause death and MACCE in patients with coronary heart disease.
【作者單位】： 河南省人民醫(yī)院心內(nèi)科監(jiān)護(hù)病房;河南省心血管流行病中心;
【基金】：河南省科技廳重點(diǎn)攻關(guān)項(xiàng)目(142102310396)
【分類號(hào)】：R541.4

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