巴楚医学

目的：探究冠心病(CAD)患者发生脑血管不良事件的独立影响因素。方法：回顾性分析2022年1月—2024年3月于宜昌市中心人民医院就诊的118例CAD患者，根据患者随访6个月后是否出现脑血管不良事件分为发生脑血管不良事件的观察组(n=28)和未发生脑血管不良事件的对照组(n=90),采用单因素及多因素Logistic回归分析CAD患者发生脑血管不良事件的独立危险因素。结果：心电图V1导联P波终末电势(PTFV1)>0.002 mm/s(OR=37.583,95%CI:11.801,119.696)、中叶素(IMD)升高(OR=1.396,95%CI:1.190,1.637)、心血管活性肽salusin-α降低(OR=2.952,95%CI:1.235,7.057)、右心房心尖四腔短径增大(OR=1.421,95%CI:1.225,1.648)是CAD患者发生脑血管不良事件的独立影响因素(均P<0.05)。绘制受试者工作特征(ROC)曲线，PTFV1>0.002 mm/s、IMD升高、salusin-α降低、右心房心尖四腔短径增大的曲线下面积(AUC)值分别为0.848、0.738、0.656、0.850。结论：PTFV1>0.002 mm/s、IMD升高、salusin-α降低及右心房心尖四腔短径增大是CAD患者发生脑血管不良事件的独立危险因素。

Objective: To explore the independent influencing factors of cerebrovascular adverse events in patients with coronary artery disease(CAD). Methods: A retrospective analysis was conducted on 118 CAD patients who visited Yichang Central People's Hospital from January 2022 to March 2024. The patients were divided into an observation group with cerebrovascular adverse events(n=28) and a control group without cerebrovascular adverse events(n=90) based on whether they experienced cerebrovascular adverse events after a 6-month follow-up. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors for cerebrovascular adverse events in CAD patients. Results: Electrocardiographic P-wave terminal force in lead V1(PTFV1) >0.002 mm/s(OR=37.583, 95%CI: 11.801,119.696), increased intermedin(IMD)(OR=1.396, 95%CI: 1.190,1.637), decreased cardiovascular regulatory peptide salusin-α(OR=2.952, 95%CI: 1.235,7.057), and increased right atrial apical four-chamber short-axis diameter(OR=1.421, 95%CI: 1.225,1.648) were independent influencing factors for cerebrovascular adverse events in CAD patients(all P<0.05). Receiver operating characteristic(ROC) curves were plotted, and the areas under the curve(AUC) for PTFV1>0.002 mm/s, increased IMD, decreased salusin-α, and increased right atrial apical four-chamber short-axis diameter were 0.848, 0.738, 0.656, and 0.850, respectively. Conclusion: PTFV1>0.002 mm/s, increased IMD, decreased salusin-α, and increased right atrial apical four-chamber short-axis diameter are independent risk factors for cerebrovascular adverse events in CAD patients.