反应性充血指数对冠心病患者PCI术后心绞痛的预测价值

目的 探讨反应性充血指数(RHI)对冠心病患者经皮冠状动脉介入治疗(PCI)术后心绞痛的预测价值.方法 至2015年10月10日至2016年8月10日,连续入选该科收治的347例冠心病且行PCI治疗的患者,住院期间所有患者均使用En-do-PAT无创血管内皮功能检测技术检测RHI.根据RHI结果分组,RHI≥1.67为对照组,RHI＜1.67为观察组,观察两组患者出院后心绞痛发生率、因心绞痛再次住院率、心绞痛发作频次和持续时间的差异.结果 对照组和观察组术后心绞痛发生率分别为17.04％和31.13％,差异有统计学意义(P=0.003);因心绞痛再次住院发生率分别2.22％和7.55％,差异有统计学意义(P=0.035);心绞痛发作大于或等于5次发生率分别为6.67％和16.51％,差异有统计学意义(P=0.008);心绞痛持续平均时间分别为(6.39±2.68)min和(8.67士2.58)min,差异有统计学意义(P=0.001);Logistic回归分析显示Syntax≥23分、RHI＜1.67是PCI术后再发心绞痛的危险因素(OR =2.265,95％CI:1.354～3.787,P=0.002;OR=2.110,95％CI:1.228～3.628,P=0.007).结论 RHI降低与PCI术后再发心绞痛密切相关,增加患者心绞痛发生率、因心绞痛再次住院率、心绞痛发作频次和持续时间.

Value of reactive hyperemia index in predicting postoperative angina pectoris in patients with percutaneous coronary intervention

Objective To explore the value of reactive hyperemia index (RHI) in predicting the postoperative angina pectoris (AP) in the patients with percutaneous coronary intervention (PCI).Methods Three hundreds and forty-seven patients with coronary heart disease treated by PCI therapy were continuously enrolled in our department from October 10 2015 to August 10 2016.RHI was detected in all cases during hospitalization period by using the noninvasive endothelial function test (Endo-PAT) technique.Then the cases were divided into the control group (RHI≥1.67) and observation group (RHI ＜1.67) according to RHI results.The incidence of AP after discharge from hospital,rehospitalization rate due to AP,frequency and duration of AP were observed in the two groups.Results The AP incidence rates in the control and observation group were 17.04％ and 31.13％ respectively,the difference was statistically significant(P=0.003);the re-hospitalization rate due to AP was 2.22％ and 7.55％ respectively,the difference was statistically significant(P =0.035);the incidence rates of AP attack≥5 times were 6.67 ％ and 16.51 ％ respectively(P=0.008);the duration of AP was (6.39±2.68) min and (8.67±2.58) min,respectively(P=0.001);the Logistic regression analysis showed that the Syntax scores≥23 points and RHI＜1.67 were the risk factors for AP recurrence after PCI(OR=2.265,95％CI:1.354-3.787,P=0.002;OR=2.110,95％CI:1.228-3.628,P=0.007).Conclusion Reduced RHI is closely related with recurrent AP after PCI,increases the incidence,rehospitalization rate due to AP,attack frequency and duration of AP.