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目的分析不同性别血运重建患者中合并代谢综合征的临床特征和预后。方法单中心注册研究(DESIRE),入选2001年7月1日至2004年6月30日在我院接受血管重建治疗,支架术或冠脉旁路移植术的所有患者,记录其临床资料,并进行门诊和电话随访,记录随访期间临床不良事件,患者死亡为随访终止,记录死亡时间。结果相应临床资料记录完整的患者2596例,其中符合我国代谢综合征患者女性(299例)明显高于男性(840例)(50.9%比41.8%,P<0.0001),随访时间为829±373 d(15～1691 d),随访成功80.8%。在女性患者中合并代谢综合征患者的心脑血管事件和死亡率增加(分别为女:12.1%,6.9%,男:10.6%,5.1%,),P=0.012]。应用 Logistic 回归分析,在校正了年龄、白细胞和肌酐水平后发现,合并代谢综合征是女性冠心病患者预后不良的惟一预测因子(OR 2.019,95%CI 1.751～2.506,P=0.023),而高血糖是合并代谢综合征患者预后不良的最重要危险因子(OR2.511,95%CI1.396～4.511,P=0.002)。结论在血运重建患者中,女性合并代谢综合征的比例明显高于男性,女性患者合并代谢综合征的预后不良,代谢综合征各成分中高血糖与不良预后直接相关。
Objective To analyze the clinical features and prognosis of metabolic syndrome in patients of different genital revascularization. Methods A single center registry study (DESIRE) was enrolled in all patients undergoing revascularization, stenting or coronary artery bypass grafting in our hospital from July 1, 2001 to June 30, 2004, and their clinical data were recorded Outpatients and telephone follow-up, recorded during follow-up of clinical adverse events, patient death was discontinued, record the time of death. Results A total of 2596 patients were recorded according to the corresponding clinical data. Among the 299 patients with metabolic syndrome, 299 (299.9%) were significantly higher than men (50.9% vs 41.8%, P <0.0001), followed up for 829 ± 373 days (15 ~ 1691 d), 80.8% of successful follow-up. Cardiovascular and cerebrovascular events and mortality were increased in women with metabolic syndrome (female: 12.1%, 6.9%, male: 10.6%, 5.1%, respectively) (P = 0.012). Logistic regression analysis showed that combined metabolic syndrome was the only predictor of poor prognosis in women with coronary heart disease (OR 2.019, 95% CI 1.751-2.006, P = 0.023) after adjusting for age, leukocyte and creatinine levels, and high Blood glucose is the most important risk factor for poor prognosis in patients with metabolic syndrome (OR 2.511, 95% CI 1.395 ~ 4.511, P = 0.002). Conclusions In patients with revascularization, the proportion of women with metabolic syndrome is significantly higher than that of men. The prognosis of women with metabolic syndrome is poor. The hyperglycemia in each component of metabolic syndrome is directly related to the poor prognosis.