共病指数与急性冠状动脉综合征患者冠状动脉病变程度及早期预后的相关性OA
Correlation study between comorbidity index and the degree of coronary artery lesions and early prognosis in patients with acute coronary syndrome
目的 探究共病指数与急性冠状动脉综合征(ACS)患者冠状动脉病变程度以及早期预后的关系.方法 选择2023 年10 月—2024 年11 月南京大学医学院附属金陵医院收治行经皮冠状动脉介入(PCI)治疗的 169 例 ACS 患者进行回顾性分析.收集患者临床相关资料,计算查尔斯共病指数(CCI),并采用 Gensini 评分对冠状动脉病变的严重程度进行量化评估,统计患者住院期间主要不良心血管事件(MACEs)的发生情况.采用 Spearman 相关性检验评估 CCI 评分与冠状动脉病变程度及 MACEs 发生的相关性,采用多因素 logistic 回归分析在院期间发生 MACEs 的风险因素,采用 ROC 曲线评估 CCI 评分对 MACEs 发生的预测能力.结果 住院期间发生 MACEs 者 40 例,未发生者 129 例.住院期间 MACEs组的年龄、糖尿病患病率、白细胞计数、尿素氮、CCI 评分、Gensini 评分、冠状动脉病变分支数、植入支架个数均高于非 MACEs 组(P<0.05).Spearman 相关性检验结果显示,CCI 评分与 ACS 患者 Gensini 评分、冠状动脉病变分支数、植入支架个数及住院期间 MACEs 的发生呈正相关(P<0.05).logistic 回归分析表明,CCI 评分是 ACS 患者住院期间发生 MACEs 的独立危险因素(OR=5.364,95%CI:2.625～10.962,P<0.001).ROC 曲线表明 CCI 评分预测 MACEs 的曲线下面积为 0.878(95%CI:0.820～0.937,P<0.001),最大约登指数为 0.608,灵敏度为 82.5%,特异度为 78.3%,最佳截断值为 2.5 分.结论 ACS 患者 CCI 与冠状动脉病变程度及 MACEs 的发生相关,针对不同 CCI 分层的患者应采取不同的预防措施.
Objective To investigate the relationship between the comorbidity index and the degree of coronary artery le-sions as well as early prognosis in patients with acute coronary syndrome(ACS).Methods A retrospective analysis was conducted on 169 ACS patients who underwent percutaneous coronary intervention(PCI)at Jinling Hospital between October 2023 and November 2024.Clinically relevant data was collected,and the Charlson comorbidity index(CCI)was calculated.The Gensini score was used to evaluate the degree of coronary artery lesions in patients.To statistically analyze the occurrence of major adverse cardiovascular e-vents(MACEs)during the hospitalization of patients.The spearman correlation test was used to evaluate the correlation between the CCI score and the degree of coronary artery lesions as well as the occurrence of MACEs.Multivariate logistic regression model was used to analyze the risk factors of MACEs during hospitalization,and the ROC curve was used to evaluate the predictive ability of CCI score for the occurrence of MACEs.Results 40 cases of MACEs occurred during hospitalization,while 129 cases did not.The MACEs group showed significantly higher values than the non-MACEs group in terms of age,prevalence of diabetes,white blood cell count,blood urea nitrogen,CCI score,Gensini score,number of diseased coronary branches,and number of implanted coronary stents(P<0.05).Spearman correlation analysis revealed that the CCI score was positively correlated with the Gensini score,number of diseased coronary branches,number of implanted stents,and the occurrence of MACEs in ACS patients(P<0.05).Logistic regression analysis indicated that the CCI score is an independent risk factor for MACEs in ACS patients(OR=5.364,95%CI:2.625-10.962,P<0.001).ROC curve analysis demonstrated that the area under the curve(AUC)for predicting MACEs using the CCI score was 0.878(95%CI:0.820-0.937,P<0.001),with a maximum Youden index of 0.608,sensitivity of 82.5%,specificity of 78.3%,and an optimal cutoff value of 2.5 scores.Conclusion The CCI is associated with the degree of coronary artery lesions and the occurrence of MACEs in ACS patients.Different preventive measures should be implemented based on patients'CCI stratification.
王清清;陈阳希;贡歌;杨晨
南京大学医学院附属金陵医院 东部战区总医院干部病房,江苏 南京 210002南京大学医学院附属金陵医院 东部战区总医院干部病房,江苏 南京 210002南京大学医学院附属金陵医院 东部战区总医院干部病房,江苏 南京 210002南京大学医学院附属金陵医院 东部战区总医院干部病房,江苏 南京 210002
急性冠状动脉综合征查尔斯共病指数冠状动脉病变程度主要不良心血管事件
Acute coronary syndromeCharlson comorbidity indexDegree of coronary artery lesionsMajor adverse cardi-ovascular events
《国际老年医学杂志》 2026 (3)
302-307,6
江苏省老年健康科研项目(LD2022001)东部战区总医院基础研究计划一般项目(22JCYYYB6)
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