冠脉搭桥与支架置入治疗冠心病多支病变的预后评价(1)
摘要：目的 比较冠心病多支血管病变(MVD)患者冠状动脉旁路移植术(CABG)与经皮冠状动脉介入治疗(PCI)两种再血管化方式的临床预后。方法 入选2013年1月～2015年12月在本院首次行血运重建术的MVD患者437例，其中CABG组212例，PCI组225例。比较两组患者围术期基线特征，随访观察两组主要终点事件的发生率，包括死亡、心源性死亡、心肌梗死、脑血管意外及再次血运重建等主要不良心脑血管意外(MACCE)，次要终点事件再发心绞痛的发生率。对比分析两种血运重建方式的预后。结果 两组患者死亡率、心源性死亡率、脑血管意外发生率无统计学差异(P>0.05)，PCI组MACCE发生率、心肌梗死发生率、再次血运重建发生率及心绞痛复发率均明显高于CABG组，差异有统计学意义(P<0.05～0.001)。结论 两组患者死亡率无明显差异，但CABG组患者术后MACCE及再次血运重建发生率低于PCI组。
关键词：冠心病；多支血管病变；冠状动脉旁路移植术；经皮冠状动脉介入治疗
, 百拇医药
Evaluation of Coronary Artery Bypass Grafting and Stent Implantation in the Treatment of Coronary Artery Disease
CAO Jing，KONG Xiang，GE Jian-jun
(Department of Cardiology，the First Affiliated Hospital of Anhui Medical University，Hefei 230022，Anhui，China)
Abstract：Objective To compare the coronary multivessel disease(MVD)patients after coronary artery bypass grafting(CABG)and percutaneous coronary intervention(PCI)clinical prognosis of two revascularization.Methods 437 MVD patients selected in January 2013～2015 year in December in our hospital for the first time to revascularization of patients，including 212 in group CABG cases，225 cases in PCI group.Compared with two groups of patients with baseline characteristics of operation period，follow-up rate，two groups of end point events including death，cardiac death，myocardial infarction，cerebrovascular accident and revascularization of major adverse cardiovascular and cerebrovascular accident(MACCE)，the incidence of recurrent angina secondary end point events the prognosis of angina pectoris.Comparative analysis of two kinds of mode of revascularization.Results Two groups of patients，mortality，cardiac death，cerebrovascular accident rate showed no significant difference(P>0.05)，the incidence of PCI in group MACCE，the incidence of myocardial infarction，revascularization the recurrence rate of angina and the occurrence rate was obviously higher than that of group CABG，the difference was statistically significant(P<0.05～0.001).Conclusion There is no significant difference between the two groups in mortality，but the patients of the CABG group after MACCE and revascularization rates lower than PCI group.
, 百拇医药
Key words：Coronary heart disease；Multivessel disease；Coronary artery bypass grafting；Percutaneous coronary intervention
冠狀动脉粥样硬化性心脏病(冠心病)已成为威胁人类健康并导致死亡的主要疾病，在我国，其发病率和死亡率呈逐年上升趋势[1]。冠心病多支血管病变(multivessel coronary artery disease，MVD)是其中较为复杂和严重的类型。冠状动脉旁路移植术(coronary artery bypass grafting，CABG)和经皮冠状动脉介入治疗(percutaneous coronary intervention，PCI)是目前治疗冠心病的主要血运重建方式。随着PCI技术的不断发展，越来越多的临床医生和患者将其作为血运重建方式的首要选择，但对于复杂冠状动脉病变再血管化方式仍然存在争议。本研究主要对冠心病多支血管病变患者行CABG与PCI术的临床预后进行对比与评价，为MVD患者血运重建策略的选择提供参考。, http://www.100md.com(曹静 孔祥 葛建军)
关键词：冠心病；多支血管病变；冠状动脉旁路移植术；经皮冠状动脉介入治疗
, 百拇医药
Evaluation of Coronary Artery Bypass Grafting and Stent Implantation in the Treatment of Coronary Artery Disease
CAO Jing，KONG Xiang，GE Jian-jun
(Department of Cardiology，the First Affiliated Hospital of Anhui Medical University，Hefei 230022，Anhui，China)
Abstract：Objective To compare the coronary multivessel disease(MVD)patients after coronary artery bypass grafting(CABG)and percutaneous coronary intervention(PCI)clinical prognosis of two revascularization.Methods 437 MVD patients selected in January 2013～2015 year in December in our hospital for the first time to revascularization of patients，including 212 in group CABG cases，225 cases in PCI group.Compared with two groups of patients with baseline characteristics of operation period，follow-up rate，two groups of end point events including death，cardiac death，myocardial infarction，cerebrovascular accident and revascularization of major adverse cardiovascular and cerebrovascular accident(MACCE)，the incidence of recurrent angina secondary end point events the prognosis of angina pectoris.Comparative analysis of two kinds of mode of revascularization.Results Two groups of patients，mortality，cardiac death，cerebrovascular accident rate showed no significant difference(P>0.05)，the incidence of PCI in group MACCE，the incidence of myocardial infarction，revascularization the recurrence rate of angina and the occurrence rate was obviously higher than that of group CABG，the difference was statistically significant(P<0.05～0.001).Conclusion There is no significant difference between the two groups in mortality，but the patients of the CABG group after MACCE and revascularization rates lower than PCI group.
, 百拇医药
Key words：Coronary heart disease；Multivessel disease；Coronary artery bypass grafting；Percutaneous coronary intervention
冠狀动脉粥样硬化性心脏病(冠心病)已成为威胁人类健康并导致死亡的主要疾病，在我国，其发病率和死亡率呈逐年上升趋势[1]。冠心病多支血管病变(multivessel coronary artery disease，MVD)是其中较为复杂和严重的类型。冠状动脉旁路移植术(coronary artery bypass grafting，CABG)和经皮冠状动脉介入治疗(percutaneous coronary intervention，PCI)是目前治疗冠心病的主要血运重建方式。随着PCI技术的不断发展，越来越多的临床医生和患者将其作为血运重建方式的首要选择，但对于复杂冠状动脉病变再血管化方式仍然存在争议。本研究主要对冠心病多支血管病变患者行CABG与PCI术的临床预后进行对比与评价，为MVD患者血运重建策略的选择提供参考。, http://www.100md.com(曹静 孔祥 葛建军)
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