天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (8): 947-950.doi: 10.11958/20150375

• 专题研究-心血管 • 上一篇    下一篇

SYNTAX 评分对接受PCI 治疗的无保护左主干病变患者的预测价值

李洁1,2 ， 张梅3   

  1. 1天津医科大学 （邮编300070）； 2天津市天津医院心内科； 3武警后勤学院附属心脏医院
  • 收稿日期:2015-12-07 修回日期:2016-04-02 出版日期:2016-08-15 发布日期:2016-08-22
  • 作者简介:李洁 （1978）， 男， 主治医师， 本科， 主要从事临床心血管疾病诊治方面研究

Evaluation of SYNTAX score in predicting prognosis of patients with unprotected left main coronary artery disease undergoing percutaneous coronary intervention

LI Jie1,2 ， ZHANG Mei 3   

  1. 1 Tianjin Medical University, Tianjin 300070, China; 2 Department of Cardiology, Tianjin Hospital; 3 Department of Cardiology, the Affiliated Hospital of PAP of Logistic College
  • Received:2015-12-07 Revised:2016-04-02 Published:2016-08-15 Online:2016-08-22

PDF (PC)

3725

摘要： 摘要： 目的 研究 SYNTAX 评分 （SxScore） 和 SYNTAXⅡ评分 （SxScoreⅡ） 对无保护左主干 （ULMCA） 冠心病患者接受经皮冠状动脉介入治疗 （PCI） 术后 30 个月的主要不良心脑血管事件 （MACCE） 的预测能力。方法 回顾性分析武警后勤学院附属医院心内科接受 PCI 治疗的 209 例 ULMCA 冠心病患者， 通过电话、 门诊和 （或） 再次入院随访患者 PCI 术后的 MACCE， 包括全因死亡、 非致命性心肌梗死、 靶血管血运重建、 卒中及次要终点事件包括心源性死亡、支架内血栓。根据冠状动脉造影结果及临床特征计算 SxScore 和 SxScoreⅡ， 根据 SxScore 标准分为低分组≤22 分，中分组 23～32 分， 高分组≥33 分， 比较 3 组的临床资料， Cox 回归评价两种评分系统对 PCI 术后 MACCE 的预测能力。结果 209 例患者中， 失访 12 例 （5.7%）， 中位随访时间为 30.2 个月， 56 例 （28.4%） 观察到 MACCE。SxScore 低、中、 高分组的MACCE发生率分别为19.0%， 28.6%和44.4%。SxScoreⅡ低、 中、 高分组的MACCE发生率分别为12.8%、 23.8%和 45.5%。单因素分析结果显示 SxScore、 SxScoreⅡ高分值、 高龄、 合并糖尿病和低左室射血分数 （LVEF） 为 MACCE 的危险因子， 多因素分析结果显示 SxScore、 SxScoreⅡ高分值仍为 MACCE 的独立危险因子。结论 SxScore 和 SxScoreⅡ对冠状动脉ULMCA 病变患者行 PCI 治疗后的 MACCE 均有预测作用。

关键词:  血管成形术, 经腔, 经皮冠状动脉, 冠状动脉疾病, 无保护左主干, SxScore, SxScoreⅡ, 主要不良心脑血管事件

Abstract: Abstract: Objective To evaluate the long- term prognostic capacity of the SYNTAX score Ⅱ(SxScore Ⅱ) and SYNTAX score (SxScore) in patients undergoing left main percutaneous coronary intervention (LM-PCI). Methods A total of 209 patients undergoing unprotected LM-PCI in the Cardiology Department of the Affiliated Hospital of PAP of Logistic College were prospectively collected. Follow up was carried out by telephone or outpatient or rehospitalization. The clinical endpoint focused on MACCE after PCI including composite death, nonfatal myocardial infarction, target vessel revascularization and stroke. The secondary endpoint included cardiac death and stent thrombosis. The SxScore and SxScore Ⅱ were retrospectively calculated according to results of coronary angiography and clinical features of patients. Patients were stratified according to tertiles of low (≤22), intermediate (23-32), and high (≥33). The clinical data were compared between three groups. The predictive ability of two scoring systems to MACCE after PCI was compared by COX regression evaluation. Results In 209 patients, 12 patients were lost to follow-up (5.7%), and the median follow-up was 30.2 months, 56 cases (28.4%) were observed to suffer from MACCE. The incidence rates of MACCE were 19.0%, 28.6% and 44.4% in SxScore low, intermediate and high groups respectively. The incidence rates of MACCE were 12.8%, 23.8% and 45.5% in SxScoreⅡlow, intermediate and high groups respectively. Single factor analysis showed that SxScore, SxScore Ⅱ, age, diabetes and left ventricular ejection fraction (LVEF) were the independent predictors of MACCE. Multivariate analysis showed that SxScore and SxScoreⅡwere still risk independent predictors for MACCE. Conclusion Both SxScore and SxScore Ⅱare independent risk predictors for MACCE in patients with unprotected left main coronary artery disease undergoing PCI treatment.

Key words: angioplasty, transluminal, percutaneous coronary, coronary artery disease, unprotected left main coronary artery, SxScore, SxScoreⅡ, major adverse cardiac and cerebrovasculur events