【摘要】 目的:探讨经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)对肿瘤合并冠状动脉慢性完全闭塞病变(chronic coronary total occlusion,CTO)患者近期预后以及生活质量的影响,以期为肿瘤合并冠心病的临床早期防治工作提供相关依据。方法:本研究为回顾性性队列研究,连续纳入2015年1月至2019年6月在成都市第五人民医院心内科进行PCI治疗的肿瘤合并CTO患者62例,术后随访12个月,收集主要不良心血管事件发生情况、评价术前及术后6个月的生活质量[西雅图心绞痛量表(Seattle Angina Questionnaire,SAQ)],采用Cox比例风险回归模型分析PCI术后影响肿瘤合并CTO患者近期预后的相关危险因素。结果:肿瘤合并CTO患者经PCI开通后其躯体活动受限程度、心绞痛稳定状态、心绞痛发作频率和治疗满意情况均明显改善,差异有统计学意义(均P<0.05);对疾病认知情况在治疗前后未见明显差异(P>0.05)。随访12～38个月,平均(18.5±3.6)个月,随访率90.3%,一级终点事件发生率为8.1%,二级终点事件发生率为9.7%,MACE的发生率为17.7%。肿瘤合并CTO患者PCI术后1年预后的多因素Cox比例风险回归分析结果显示:性别为男性(HR=3.040)、年龄70～85岁(HR=2.677)、术中不良事件(HR=2.434)是其术后1年内发生不良心血管事件的独立危险因素。结论:在优化药物治疗基础上,PCI手术能改善肿瘤合并CTO患者术后躯体活动受限程度、心绞痛稳定状态、心绞痛发作频率等生活质量。性别为男性、年龄70～85岁、术中不良事件是影响成功开通CTO患者1年的MACE总发生率的危险因素。更多还原

【Abstract】 Objective: To explore the effect of percutaneous coronary intervention(PCI) on the short-term prognosis and quality of life of patients with chronic coronary total occlusion(CTO) complicated with tumor, in order to provide evidence for the early prevention and treatment of target patients. Methods: A retrospective cohort study was conducted. 62 patients with CTO complicated with tumor who underwent PCI in the department of cardiology in Chengdu Fifth People’s Hospital from January 2015 to June 2019 were followed up for 12 months. The occurrence of major adverse cardiovascular events(MACE) and the quality of life before and 6 months after operation were collected and evaluated with Seattle Angina Questionnaire. Cox proportional hazard regression model was used to analyze the risk factors affecting the short-term prognosis of patients with coronary heart disease after PCI. Results: Scores of Physical Limitation Scale, Anginal Stability Scale, Anginal Frequency Scale and Treatment Satisfaction Scale of CTO patients significantly improved after PCI(all P<0.05), and there was no significant difference in scores of Disease Perception Scale before and after treatment(P>0.05). Follow-up time ranged from 12 to 38 months, with an average of(18.5±3.6) months. The follow-up rate was 90.3%. The incidence of primary endpoint events was 8.1%. The incidence of secondary endpoint events was 9.7%. The total incidence of MACE was 17.7%. Multivariate Cox proportional risk regression analysis of 1-year prognosis of CTO patients complicated with tumor after PCI showed that gender(HR=3.040), age 70-85(HR=2.677), and intraoperative adverse events(HR=2.434) were independent risk factors for adverse cardiovascular events within 1 year after PCI. Conclusion: PCI with optimized drugs can improve physical limitation, anginal stability, anginal frequency and other facets of the quality of life of CTO patients complicated with tumor. Male, age 70-85, and intraoperative adverse events were risk factors of the 1-year overall incidence of MACE in CTO patients after PCI.更多还原