介入性完全性血运重建对冠状动脉多支病变患者长期预后的影响  

The Effect of Long-term Outcomes between Complete and Incomplete Interventional Revascularization in Patients with Mutivessel Coronary Disease

作　　者：罗亚玮[1] 陈方[1] 张维东[1] 高阅春[1] 张晓玲[1] 李峥[1] 何继强[1] 李宇[1] 韩智红[1] 赵华[1] 汪烨[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科,100029

出　　处：《临床放射学杂志》2008年第10期1394-1397,共4页Journal of Clinical Radiology

摘　　要：目的比较单支和多支冠状动脉病变患者经皮冠状动脉介入术(PCI)后的远期预后以及实施完全性或不完全性血运重建对后者长期临床疗效的影响。资料与方法959例冠心病患者行选择性冠状动脉内支架置入术,其中单支病变组(single-vessel disease,SVD)362例,多支病变完全性血运重建组(complete revascularization,CR)291例,多支病变不完全性血运重建组(incomplete revascularization,IR)306例,对比分析3组患者PCI手术后2.5年随访结果。结果与CR组比较,IR组患者中冠状动脉病变严重程度、3支病变比例、左主干病变、分叉病变数量均高(P<0.05),病变数目少而平均置入支架数多(P<0.05)。SVD组冠状动脉病变平均狭窄程度重而植入支架长度和直径均小于另两组(P<0.05)。IR组再发心绞痛(P<0.05)、再次血运重建比例(P<0.01)和MACE事件发生率(P<0.05)均显著高于另两组。结论通过行PCI术实现完全性血运重建的多支冠状动脉病变患者长期预后效果与单支病变者类似,优于不完全性血运重建者。Objective To compare the long term outcome between single vessel coronary disease （SVD） patients and muhivessel coronary disease （MVD）patients by percutaneous coronaral intervention （PCI） and investigate the effective factors for the effectiveness of complete and incomplete revaseularization in patients with MVD. Materials and Methods Total 959 consecutive patients with coronary heart disease who underwent PCI included 362 SVD patients with complete revascularization （CR） , 291 MVD patients with CR, and 306 MVD patients with incomplete revascularization （IR）. The long-term follow-up outcome for about 2.5 years were analyzed among the three groups. Results The rate of triple vessel disease,left main artery lesion, bifurcation lesion and the number of stents in IR group was significantly higher than those in CR group . The rate of rehospitalization of CR group and IR group was higher than that of SVD group. The rate of angina recurrence, revascularization and major adverse cardiac events （MACE） was significantly higher in IR group than those in other two group. Conclusion Long-term clinical outcome in MVD patients with complete revascularization by PCI was similar to SVD patients, which was better than that in MVD patients with incomplete interventional revaseularization.

关 键 词：冠状动脉疾病 血运重建 血管成形术 

分 类 号：R541.4[医药卫生—心血管疾病]