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Received:April 26, 2019 Published Online:January 20, 2020
Received:April 26, 2019 Published Online:January 20, 2020
中文摘要: 目的 探讨不同类风湿因子(RF)水平对冠心病接受经皮冠状动脉介入治疗术(PCI)患者心功能、并发症及生活质量的影响。
方法 回顾性分析2016年10月至2018年10月接受PCI治疗的冠心病患者的临床资料,将符合入组标准的200例患者,根据术前血清不同RF水平分为两组,RF正常组(RF<20 U/ml)132例,RF高水平组(RF≥20 U/ml)68例。对比两组患者基本资料、治疗效果和并发症发生率。
结果 两组糖尿病、高血压、高脂血症、吸烟率和性别、身高、血小板计数、白细胞计数、纤维蛋白原水平比较均无统计学差异(P均>0.05);而年龄、高敏C反应蛋白水平、置入支架数、支架总直径、冠状动脉病变程度及支架总长度组间比较差异有统计学意义(P<0.05,P<0.01)。PCI术治疗1个月后,RF正常组较RF高水平组左心室射血分数(LVEF)、左心室舒张期末内径(LVEDd)、生存质量评分升高,术后并发症发生率下降(P<0.05,P<0.01);Logistic回归分析显示,置入支架数、支架总直径、冠状动脉病变程度均是RF水平升高的独立影响因素(P均<0.01)。
结论 冠心病患者血清RF水平与冠状动脉病变程度以及PCI术后心功能、并发症及生活质量密切相关,RF水平越高出现严重冠心病和术后并发症的风险越高。
中文关键词: 类风湿因子 冠心病 经皮冠状动脉介入治疗术 心功能指标 生存质量评分
Abstract:Objective To explore the effects of different rheumatoid factor(RF) levels on cardiac function,complications and quality of life in patients with coronary heart disease(CHD) undergoing percutaneous coronary intervention (PCI).
Methods The clinical data of CHD patients receiving PCI from October 2016 to October 2018 were retrospectively analyzed,and 200 patients meeting the inclusion criteria were selected and divided into RF normal group (RF<20 U/ml,n=132),RF high level group (RF≥20 U/ml,n= 68) according to preoperative serum RF levels.The basic data of patients,therapeutic effect and complication rate were observed and compared between two groups.
Results There were no significant differences in diabetes,hypertension,hyperlipidemia,smoking rates and gender,height,platelet count,leukocyte count and fibrinogen levels between the groups(all P>0.05),but there were statistical differences in the age,high-sensitivity C-reactive protein level,number and total diameter of stents,degree of coronary lesions and the total length of the stents between two groups(P<0.05,P<0.01).After 1 month of PCI,the left ventricular ejection fraction (LVEF) and quality of life scores significantly increased,and the incidence of postoperative complications significantly decreased in RF normal group compared with RF high level group (P<0.05,P<0.01).The Logistic regression analysis showed that number and total diameter of stents,the degree of coronary lesions were independent infuencing factors of high RF level(all P<0.01).
Conclusions In patients with CHD,the level of serum RF is closely related to the degree of coronary lesions,cardiac function,complications and quality of life after PCI.The higher the level of RF,the higher the risk of serious CHD and postoperative complications.
keywords: Rheumatoid factor Coronary heart disease Percutaneous coronary intervention Cardiac function index Quality of life score
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