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目的 伴随着肥胖与超重的流行,体重问题已经被日益关注.已知的证据表面肥胖是冠心病的危险因素,但是肥胖是否可以增加冠心病的死亡风险,目前尚无定论.三支病变是严重冠心病人群,冠脉介入治疗是除冠脉搭桥术之外该人群的重要治疗手段.肥胖和超重是否能增加介入术后三支病变患者的死亡风险需要进一步去探讨.方法 本研究入选了2004-2011年在阜外医院住院的行冠脉介入治疗的三支病变的患者3722例,收集基线资料,并随访7.1年.将入组的患者依据不同的BMI分为体重过轻组(＜18.5 kg/m2)、正常体重组(18.5-23.9 kg/m2)、超重组(24-27.9 kg/m2)、轻度肥胖组(28-31.9 kg/m2)重度肥胖组(≥32kg/m2).比较不同的BMI组别全因死亡及心血管死亡的差别.结果 相对于正常体重组,体重过轻组的全因死亡无显著差别(HR:0.59;0.14-2.38).相对于体重正常组,超重组和轻度肥胖组的全因死亡有减少趋势但无统计学意义(HR:0.90;0.71-1.12)、(HR:0.90;0.66-1.23).相对于体重正常组,超重组的心血管死亡有减少趋势无统计学意义(HR:0.89;0.63-1.24).重度肥胖组相对于体重正常组,全因死亡及心血管死亡有增加的趋势但无统计学意义(HR:1.45;0.87-2.44)、(HR:1.25;0.56-2.79).结论 在行冠脉介入治疗的冠脉三支病变的人群中,未见到BMI与全因死亡及心血管死亡有显著相关性.“,”Objective Weight has become increasingly concerned with the prevalence of obesity and overweight.Many evidences suggested obesity is a risk factor of coronary heart disease.However,it is still not clear whether obesity can increase the mortality risk of coronary heart disease especially for triple-vessel disease.Percutaneous coronary intervention (PCI) is an important means of treatment in addition to coronary artery bypass surgery for triple-vessel disease.Whether obesity and overweight can increase the risk in these patients after PCI need further discussion.Method The study enrolled 3722 patients with triple-vessel disease who were treat with PCI in Fuwai Hospital from 2004 to 2011.The baseline data were collected and followed up for 7.1 years.They were classified based on BMI as follows:underweight (＜18.5 kg/m2),normal weight (18.5 to 23.9 kg/m2),overweight:(24 to 27.9 kg/m2),mildly obesity (28 to 31.9 kg/m2) and severe obesity (≥32 kg/m2).We analyze the differences in all-cause death and cardiovascular death between the five-weight groups.Results Compared with the normal weight group,the all-cause death in the underweight group were not significantly different (HR:0.59;0.14-2.38).Compared with the normal weight group,all-cause death in the group of overweight and obese group had decreasing trend,but no statistical significance was found (HR:0.90;0.71-1.12),(HR:0.90;0.66-1.23).Compared with the normal weight group,cardiovascular death in the group of overweight also had decreasing trend but no significant difference(HR:0.89;0.63-1.24).In the severe obesity group,all-cause death and cardiovascular death had an increasing trend compared with the normal weight group,but there was also no statistical significance (HR:1.45;0.87-2.44),(HR:1.25;0.56-2.79).Conclusion There is no significant correlation between BMI and all causes-death among the triple-vessel disease of patients undergoing PCI,the same outcome also for cardiovascular death.