中山大学学报（医学科学版）2026，Vol.47Issue(4)：594-600,7.DOI:10.11714/jsysu.med.YX20260016
围术期肌钙蛋白管理对老年结直肠肿瘤患者心脏事件发生的关联
Association Between Perioperative Troponin Management and Major Adverse Cardiac Events in Elderly Patients with Colorectal Cancer
摘要
Abstract
[Objective]To investigate the association between perioperative troponin elevation and the occurrence of major adverse cardiac events(MACE)in elderly patients with colorectal cancer,and to provide evidence for optimizing perioperative management strategies.[Methods]A total of 268 elderly patients aged 70 years and above who underwent colorectal cancer surgery were retrospectively enrolled.They were divided into a conventional management group(87 cases)and a standardized management group(181 cases)according to the perioperative management strategy.Binary logistic regression analysis was used to identify the independent influencing factors for the occurrence of major adverse cardiac events.P-value≤0.05 was considered statistically significant.[Results]Among the 268 patients,the overall incidence of perioperative major adverse cardiac events was 4.5％(12/268).The total incidence of major adverse cardiac events in the conventional management group was 8.0％(7/87),which was significantly higher than that in the standardized management group(2.8％,5/181;P=0.05).Specifically,the incidences of myocardial infarction,heart failure,and death in the conventional management group were markedly higher than those in the standardized management group(8.0％vs.2.2％,4.6％vs.0.6％,4.6％vs.0.6％,all P<0.05),while no significant difference was observed in the incidence of cardiogenic shock between the two groups(1.1％vs.1.1％,P>0.05).Postoperative troponin elevation was significantly associated with the occurrence of perioperative major adverse cardiac events except for cardiogenic shock(including total cardiovascular events,myocardial infarction,heart failure,and death)(all P<0.05),and it was identified as a strong independent risk factor for perioperative major adverse cardiac events in these patients.[Conclusion]Compared with conventional management,standardized perioperative troponin management can significantly reduce the risks of myocardial infarction,heart failure,and death,and also exhibits a potential protective trend against cardiogenic shock.Postoperative troponin elevation is a strong independent risk factor for the occurrence of perioperative major adverse cardiac events.关键词
老年结直肠癌/围术期/肌钙蛋白/心脏事件/风险管理Key words
elderly colorectal cancer/perioperative period/troponin/major adverse cardiac events/risk management分类
医药卫生引用本文复制引用
娄雪,张楚逸,薛娇洁,陈志冲,程诗尧,曾伟杰,欧阳茂..围术期肌钙蛋白管理对老年结直肠肿瘤患者心脏事件发生的关联[J].中山大学学报（医学科学版）,2026,47(4):594-600,7.基金项目
广东省自然科学基金(2025A1515012484) （2025A1515012484）
中山大学附属第六医院临床医学研究"1010"计划[1010PY(2023)-17] （2023）
