围术期肌钙蛋白管理对老年结直肠肿瘤患者心脏事件发生的关联OA
Association Between Perioperative Troponin Management and Major Adverse Cardiac Events in Elderly Patients with Colorectal Cancer
[目的]探讨老年结直肠癌患者围术期肌钙蛋白升高与心脏事件发生的关联,为优化围术期管理策略提供依据.[方法]回顾性纳入268例70岁及以上老年结直肠癌手术患者,根据围术期管理方式分为常规管理组(87例)和规范管理组(181例).采用二元Logistic回归分析心脏事件发生的独立影响因素.以P≤0.05为差异具有统计学意义.[结果]268例患者中,围术期心脏事件总发生率4.5%(12/268).常规管理组心脏事件总发生率(8.0%)明显高于规范管理组(2.8%;P=0.05),其中心肌梗死、心力衰竭及死亡发生率常规管理组均显著高于规范管理组(8.0%vs.2.2%、4.6%vs.0.6%、4.6%vs.0.6%;P＜0.05),而心源性休克发生率(1.1%vs.1.1%)无明显差异(P＞0.05).术后肌钙蛋白水平升高与除心源性休克外围术期心血管事件(总心血管事件、心肌梗死、心力衰竭、死亡)发生有明确相关(P＜0.05),是此类患者围术期心血管事件发生的强独立危险因素.[结论]围术期肌钙蛋白规范管理较常规管理可显著降低心肌梗死、心力衰竭及死亡风险,对心源性休克亦呈潜在保护趋势.术后肌钙蛋白水平升高是围术期心血管事件发生的强独立危险因素.
[Objective]To investigate the association between perioperative troponin elevation and the occurrence of major adverse cardiac events(MACE)in elderly patients with colorectal cancer,and to provide evidence for optimizing perioperative management strategies.[Methods]A total of 268 elderly patients aged 70 years and above who underwent colorectal cancer surgery were retrospectively enrolled.They were divided into a conventional management group(87 cases)and a standardized management group(181 cases)according to the perioperative management strategy.Binary logistic regression analysis was used to identify the independent influencing factors for the occurrence of major adverse cardiac events.P-value≤0.05 was considered statistically significant.[Results]Among the 268 patients,the overall incidence of perioperative major adverse cardiac events was 4.5％(12/268).The total incidence of major adverse cardiac events in the conventional management group was 8.0％(7/87),which was significantly higher than that in the standardized management group(2.8％,5/181;P=0.05).Specifically,the incidences of myocardial infarction,heart failure,and death in the conventional management group were markedly higher than those in the standardized management group(8.0％vs.2.2％,4.6％vs.0.6％,4.6％vs.0.6％,all P<0.05),while no significant difference was observed in the incidence of cardiogenic shock between the two groups(1.1％vs.1.1％,P>0.05).Postoperative troponin elevation was significantly associated with the occurrence of perioperative major adverse cardiac events except for cardiogenic shock(including total cardiovascular events,myocardial infarction,heart failure,and death)(all P<0.05),and it was identified as a strong independent risk factor for perioperative major adverse cardiac events in these patients.[Conclusion]Compared with conventional management,standardized perioperative troponin management can significantly reduce the risks of myocardial infarction,heart failure,and death,and also exhibits a potential protective trend against cardiogenic shock.Postoperative troponin elevation is a strong independent risk factor for the occurrence of perioperative major adverse cardiac events.
娄雪;张楚逸;薛娇洁;陈志冲;程诗尧;曾伟杰;欧阳茂
中山大学附属第六医院心内科,广东 广州 510655||广州市黄埔区中六生物医学创新研究院,广东 广州 510005中山大学附属第六医院麻醉科,广东 广州 510655||广州市黄埔区中六生物医学创新研究院,广东 广州 510005中山大学附属第六医院心内科,广东 广州 510655||广州市黄埔区中六生物医学创新研究院,广东 广州 510005中山大学附属第六医院心内科,广东 广州 510655||广州市黄埔区中六生物医学创新研究院,广东 广州 510005中山大学附属第六医院心内科,广东 广州 510655||广州市黄埔区中六生物医学创新研究院,广东 广州 510005中山大学附属第六医院心内科,广东 广州 510655||广州市黄埔区中六生物医学创新研究院,广东 广州 510005中山大学附属第六医院心内科,广东 广州 510655||广州市黄埔区中六生物医学创新研究院,广东 广州 510005
医药卫生
老年结直肠癌围术期肌钙蛋白心脏事件风险管理
elderly colorectal cancerperioperative periodtroponinmajor adverse cardiac eventsrisk management
《中山大学学报（医学科学版）》 2026 (4)
594-600,7
广东省自然科学基金(2025A1515012484)中山大学附属第六医院临床医学研究"1010"计划[1010PY(2023)-17]
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