【摘要】 目的 分析冠心病患者非心脏手术围术期主要心血管不良事件（MACE）的危险因素。方法 回顾性分析2014-01-01/2019-12-31期间在广西医科大学第一附属医院接受非心脏手术冠心病患者619例，根据是否发生MACE将患者分为事件组（n=36）和非事件组（n=583），采用多因素Logistic回归分析冠心病患者围术期MACE的独立危险因素。观察终点为麻醉开始至患者出院期间发生的MACE，包括恶性心律失常、心肌梗死、心力衰竭及心源性死亡，记录及比较2组患者临床资料。结果 冠心病患者非心脏手术围术期MACE发生率为5.8%(36/619)。多因素Logistic回归分析显示，ASAⅣ级（OR=18.515）、脑血管病史（OR=3.599）、不稳定性心绞痛史（OR=5.152）、心肌梗死史（OR=5.421）、急诊手术（OR=4.551）、腹部手术（胃肠、肝胆手术）（OR=10.384）、术中出血量500～1500 mL(OR=21.055)及术中出血量≥1500 mL(OR=83.885)是冠心病患者非心脏手术围术期MACE的危险因素（P <0.05），差异有统计学意义。结论 ASAⅣ级、脑血管病史、不稳定性心绞痛史、心肌梗死史、急诊手术、腹部手术（胃肠、肝胆手术）、术中出血量是冠心病患者非心脏手术围术期MACE的危险因素。更多还原

【Abstract】 Objective To analyze risk factors of major adverse cardiovascular events(MACE) in patients with coronary artery disease(CAD) undergoing noncardiac surgery. Methods A total of 619 patients with CAD who underwent noncardiac surgery from January 2014to December 2019 were retrospectively analyzed and divided into event group(n = 36) and non-event group(n = 583). The risk factors of MACE were identified by multivariate logistic regression analysis. The endpoint was MACE, which include maligant arrhythmia, myocardial infarction, heart failure and cardiac death during and after surgery until hospital discharge. The data were recorded and compared between the two groups. Results For patients with CAD undergoing noncardiac surgery, the incidence of MACE was 5.8%(36/619). According to the multivariate logistic regression analysis, the risk fators of MACE were ASA Ⅳ（OR = 18.515）, history of cerebrovascular disease(OR = 3.599), history of unstable angina(OR = 5.152), history of myocardial infarction(OR = 5.421), emergency operation(OR = 4.551), abdominal surgery(gastrointestinal and hepatobiliary surgery)(OR = 10.384), the intraoperative blood loss volume （≥500m L to < 1500 mL）(OR = 21.055) and blood loss volume （≥1500 mL）(OR = 83.885)(P < 0.05), with statistical significance.Conclusion ASA Ⅳ, history of cerebrovascular disease, history of unstable angina, history of myocardial infarction, emergency operation, abdominal surgery(gastrointestinal and hepatobiliary surgery) as well as blood loss during operation are risk factors of MACE in patients with CAD undergoing noncardiac surgery更多还原