介入性完全性血运重建对冠状动脉多支病变患者预后的影响(1)
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2010年3月25日
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[摘要] 目的:探讨介入性完全性血运重建与非完全性血运重建对多支冠状动脉病变患者预后的影响。方法:回顾性分析接受介入治疗的117例多支冠状动脉病变患者的临床资料及随访情况,根据主要的冠状动脉及其重要分支是否完全再血管化分为完全血运重建组(CR组,45例)和非完全血运重建组(IR组,72例),比较两组患者围术期死亡率、随访期间心血管总死亡率、急性心脏事件发生率和因心血管原因再次入院率。结果:两组患者的性别构成、原发性高血压、高脂血症、吸烟等相比差异均无统计学意义,非完全血运重建组糖尿病患病率及心肌梗死病史例数较高(分别为44.4%、23.6%,P<0.05)。与 CR组比较,IR组患者冠状动脉重度狭窄(P<0.05)、3支病变(P<0.05)及复杂病变(P<0.01)比例均高,病变数目少而平均置入支架数多(P<0.05)。随访6～36个月,IR组再发心绞痛(P<0.01)、再次血运重建比例(P<0.05)和 MACE事件发生率(P<0.01)均显著高于CR组。结论:与非完全血运重建相比,完全血运重建能显著改善冠心病多支病变患者的预后,对于冠心病多支病变患者,应尽可能达到完全血运重建或功能上的完全血运重建。
[关键词] 冠状动脉疾病;心肌血运重建;冠状动脉介入治疗
[中图分类号] R541.4 [文献标识码]A [文章编号]1674-4721(2010)03(c)-026-03
The effect of complete or incomplete interventional revascularization on prognosis of patients with multivessel coronary artery disease
ZHAI Xuan,DIAO Qing,LIU Zhaojun,WANG Hong
(Department of Cardiology,the Fifth People′s Hospital of Shenyang City,Shenyang 110023, China)
[Abstract] Objective: To investigate the effect of complete or incomplete interventional revascularization on prognosis of patients with multivesse coronary artery disease. Methods: 117 patients with multivessel coronary artery disease were retrospectively studied by their clinical and follow-up data after intervention.Those patients were divided into group CR(n=45) and group IR(n=72) according to complete or incomplete revascularization in the major coronary arteries.Comparision of the mortality rate of peri-intervention,total cardiovascular mortality rate during Follow-up,major acute cardiac events,and the rate of readmitted for cardiovascular disease were compared between two group. Results: There were no differences in sex,hypertension,hyperlipidemia,smokers between two groups(P>0.05).There were more diabetes mellitus and history of old cardiomyo infarction in group IR than group CR (44.4% and 23.6%,P<0.05).The rate of triple vessel disease(P<0.05),severe coronary stenosis(P<0.05) and complex coronary disease(P<0.01) in IR group were significantly higher than those in CR group,the number of coronary artery disease was little and used more stents than those in CR group(P<0.05) ......
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