远端缺血预处理对髋部骨折老年患者术后1年心血管事件的影响
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作者Author单位AddressE-Mail
张丽娜 ZHANG Li-na 濮阳市中医院麻醉科, 河南 濮阳 457000 Department of Anesthesia, Puyang Hospital of Traditional Chinese Medicine, Puyang 457000, Henan, China lina8899nali@126.com 
张艳阁 ZHANG Yan-ge 濮阳市中医院麻醉科, 河南 濮阳 457000 Department of Anesthesia, Puyang Hospital of Traditional Chinese Medicine, Puyang 457000, Henan, China  
伍永权 WU Yong-quan 濮阳市中医院骨科, 河南 濮阳 457000 Department of Orthopaedics, Puyang Hospital of Traditional Chinese Medicine, Puyang 457000, Henan, China  
期刊信息:《中国骨伤》2024年,第37卷,第5期,第487-491页
DOI:10.12200/j.issn.1003-0034.20220781
基金项目:
中文摘要:

目的:探讨远端缺血预处理(remote ischemic preconditioning,RIPC)对髋部骨折老年患者术后1年发生心血管不良事件(major adverse cardiovascular events,MACEs)的影响。

方法:2015年4月至2020年5月经手术治疗髋部骨折老年患者314例,男116例,女198例;年龄60~76岁;均为美国麻醉医师协会(American Society of Anesthesiologists,ASA)Ⅱ-Ⅲ级。所有患者进行常规麻醉,根据是否进行RIPC将患者分为两组,157例在常规麻醉基础上应用RIPC为干预组,男56例,女101例,年龄(68.12±7.13)岁;另157例为对照组,男60例,女97例,年龄(68.24±7.05)岁。对比分析两组患者术后1年的MACEs事件。

结果:应用RIPC髋部骨折患者术后1年发生心肌梗死、心力衰竭、脑卒中、非致命性心搏停止、冠状动脉血运重建术、严重心律失常、周围动脉血栓形成、心血管疾病再住院、术后1年全因死亡影响的OR值分别是1.269、1.304、0.977、1.089、1.315、1.335、0.896、0.774、1.191,但差异均无统计学意义(P>0.05)。

结论:髋部骨折术后1年内,RIPC并未明显影响改变主要心血管不良事件的发生。非心脏手术中RIPC对临床心血管结局的长期影响需要在适当的随机临床试验中得到证实。
【关键词】远端缺血预处理  髋部骨折  心血管事件
 
Effect of distal ischemic preconditioning on cardiovascular events in adult patients with hip fracture one year after operation
ABSTRACT  

Objective To investigate the effect of remote ischemic preconditioning (RIPC) on major adverse cardiovascular events (MACE) in elderly patients with hip fracture 1 year after operation.

Methods Total of 314 elderly patients with hip fracture of gradeⅡand Ⅲ for American Society of Anesthesiologists (ASA) were treated by surgical operation from April 2015 to May 2020 including 116 males and 198 females,the age ranged from 60 to 76 years old. The subjects were divided into intervention group and control group according to whether received RIPC. Among them,157 cases in intervention group included 56 males and 101 females with an average age of (68.12±7.13) years old and 157 cases in control group included 60 males and 97 females with an average age of (68.24±7.05) years old. Both groups were given routine anesthesia. The intervention group was treated with RIPC on the basis of routine anesthesia. The MACE events 1 year after operation in two groups were compared and analyzed.

Results The OR values of RIPC for myocardial infarction,heart failure,stroke,nonfatal cardiac arrest,coronary revascularization,severe arrhythmia,peripheral artery thrombosis,readmission of cardiovascular disease,and all-cause death in patients with hip fracture one year after operation were 1.269,1.304,0.977,1.089,1.315, 1.335,0.896, 0.774,1.191,respectively,but there was no significant difference (P>0.05).

Conclusion RIPC did not significantly affect and change the occurrence of major cardiovascular adverse events within 1 year after hip fracture surgery. The long term impact of RIPC on clinical cardiovascular outcomes in non cardiac surgery needs to be confirmed in appropriate randomized clinical trials.
KEY WORDS  Distal ischemic preconditioning  Hip fracture  Cardiovascular events
 
引用本文,请按以下格式著录参考文献:
中文格式:张丽娜,张艳阁,伍永权.远端缺血预处理对髋部骨折老年患者术后1年心血管事件的影响[J].中国骨伤,2024,37(5):487~491
英文格式:ZHANG Li-na,ZHANG Yan-ge,WU Yong-quan.Effect of distal ischemic preconditioning on cardiovascular events in adult patients with hip fracture one year after operation[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(5):487~491
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