不同冠状动脉重建术治疗非ST段抬高急性心肌梗死的效果  

Comparison of different coronary revascularization in patients with non ST segment elevation acute myocardial infarction

作　　者：刘玉洁[1] 陈刚[1] 陈闽荔[1] 袁如玉[2] 张颖[1] 杨丽[1] 董军[1] 赵茹[1] 刘寅[1] 孙根义[1] 

机构地区：[1]天津市胸科医院,天津300051 [2]天津市南开医院,天津300195

出　　处：《中国心血管杂志》2007年第6期430-433,共4页Chinese Journal of Cardiovascular Medicine

基　　金：国家人事部出国留学人员择优项目(项目编号2002-11)

摘　　要：目的比较经皮冠状动脉介入治疗(PCI)和冠状动脉旁路移植术(CABG)治疗非ST段抬高急性心肌梗死(NSTEAMI)的临床效果。方法98例NSTEAMI患者入院后行PCI和CABG治疗,进行12个月的随访,比较两组患者的一般临床资料、冠状动脉造影血管病变情况及心源性病死率、再发心绞痛以及再入院率和再次血运重建术率。结果CABG组三支和完全闭塞冠状动脉病变例数明显高于PCI组(87.23%vs.47.06%,87.23%vs.23.53%,P<0.05),随访12个月两组患者在心源性病死率、合并心律失常和再次血管重建术发生率(P>0.05)差异无统计学意义。而在心绞痛复发和再次住院率经皮冠状动脉成形术组高于CABG组(21.57%vs.6.38%,23.52%vs.6.38%,P<0.05)。结论对NSTEAMI患者入院后行PCI与CABG治疗是安全的血运重建的重要手段,应根据患者的具体情况采用合理的血运重建方式,以达到最佳重建冠状动脉血流的结果,改善患者的预后。Objective To compare the clinical efficacy of percutaneous coronary intervention （PCI） and coronary artery bypass grafting （CABG） in treating patients with non ST segment elevation acute myocardial infarction （NSTEAMI）. Methods Ninety-eight NSTEAMI patients were divided into PCI group and CABG group. General clinical data, angiographic characteristics, cardiac death rate, angina reoccurrence, re-revascularization, re-hospitalization were recorded and analyzed in hospital and during 12 months＇ follow-up. Results Rates of trivessel disease and chronic total occlusion （CTO） were significantly higher in CABG group than in PCI group （87. 23% vs. 47.06%, 87. 23% vs. 23.53%, P〈0. 05）, no significant difference was observed in the rates of cardiac death, arrhythmia, coronary re-revascularization between 2 groups （P〉0.05）. Reoccurrence of angina and re-hospitalization in PCI group were higher than that in CAI3G group （21. 57% vs. 6.380%, 23.52% vs. 6.38%, P〈0.05）. Conclusions PCI and CABG are both safe strategies treating NSTEAMI patients. To obtain optimal revascularization results and to improve clinical prognosis, we should choose the strategy according to the specific clinical and coronary characteristics of the patient.

关 键 词：非ST段抬高急性心肌梗死 冠状动脉重建术 经皮冠状动脉介入治疗 冠状动脉旁路移植术 

分 类 号：R654.2[医药卫生—外科学]