体重指数与进行血管重建的冠心病患者预后的关系Impact of body mass index on Clinical Outcomes in Patients Undergoing Coronary Revascularization
康俊萍,马长生,吕强,聂绍平,刘新民,刘小慧,杜昕,胡荣,董建增,陈方,吕树铮,顾承雄,黄方炯,吴学思
摘要(Abstract)：
目的了解体重指数(BMI)对接受血管重建治疗的冠心病患者预后的影响。方法DESIRE-plus为单中心回顾性注册研究,入选2004年7月1日至2005年9月30日在北京安贞医院接受血管重建治疗的3632例患者,2006年9月1日到11月30日对患者进行电话或门诊随访。本研究入选DESIRE-plus中有体重指数(BMI)资料的病例2895例。将这些患者按BMI分为四组,BMI<20组(低体重组),BMI20～24.9组(正常体重组),BMI25～29.9(超重组)和BMI≥30(肥胖组),比较不同组别之间的临床情况和预后情况。不良心脑血管事件(MACCE)包括全因死亡、非致死性心肌梗死、非致死性卒中和再次血管重建。结果低体重组92例,正常体重组1106例,超重组1454例,肥胖组243例。平均随访542d,与正常体重的患者相比,在调整了其他因素后,低体重组总死亡风险最高(HR2.711,95%CI1.159～6.341),超重组(HR0.926,95%CI0.541～1.588)和肥胖组(HR0.151,95%CI0.019～1.178)的总死亡风险并未增加。BMI对总MACCE及心血管病死亡无显著影响。结论在进行血运重建的冠心病患者中,尽管超重和肥胖者相对体重正常者有更多的危险因素,但是接受血运重建治疗后的预后不比体重正常者差,而低体重者的死亡风险增加。
关键词(KeyWords)： 体重;血管成形术,经腔,经皮冠状动脉;冠状动脉分流术;预后
基金项目(Foundation): 国家重点基础研究发展计划(九七三计划,2003CB517103)
作者(Author): 康俊萍,马长生,吕强,聂绍平,刘新民,刘小慧,杜昕,胡荣,董建增,陈方,吕树铮,顾承雄,黄方炯,吴学思
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