经皮冠脉介入治疗无保护左主干病变的临床疗效观察  

Clinical Obsvervation of Percutaneous Coronary Intervention for Unprotected Left Main Coronary Artery

作　　者：孙显东[1] 杨波[1] 计晓玲[1] 

机构地区：[1]赤峰市医院心内科,内蒙古赤峰024000

出　　处：《内蒙古医学杂志》2012年第11期1297-1300,共4页Inner Mongolia Medical Journal

摘　　要：目的：评价经皮冠状动脉介入治疗（PCI）冠心病无保护左主干病变（ULMCA）的临床疗效。方法：2006年1月~2012年2月共入选32例经皮冠状动脉介入治疗冠心病的患者,年龄33~83岁,平均年龄（61.1±12.8）岁,男性24例（75%）,有糖尿病者6例（18.8%）,有高血压者14例（43.8%）,吸烟8例（25%）,高血脂10例（31%）。分析32例患者临床特征、冠脉造影结果、PCI后即刻效果及随访6~42个月结果。随访终点指标：主要不良心脏事件（MACE）率、再发心绞痛发生率,支架血栓发生率。结果：32例ULMCA患者冠脉介入治疗均获得成功,共植入国产药物洗脱支架48枚。其中左主干开口部狭窄13例（40.6%,13/32）,体部狭窄9例（28.1%,9/32）,远端分叉部狭窄10例（31.3%,10/32）。住院期间死亡率3.1%,随访6~42个月无支架内血栓形成,心绞痛复发率12.5%,靶血管血运重建率（TVR）9.4%,MACE率12.5%。结论：经皮冠状动脉介入治疗冠心病无保护左主干病变是可行和安全的,近期、远期效果良好。Objective： To evaluate the prognosis and effect of percutaneous coronary intervention for unprotected left main coronary artery. Methods： We summarized 32 patients who underwent unprotected left main coronary artery stenting by percutaneous coronary intervention（PCI） from January 2006 to February 20120 The patients mean ages was （61.1 ± 12.8） years, consist of man 24 （75 % ）, diabetes 6 （ 18.8 % ）, hypertension 14 （43.8 % ）, hyperlipidemia 10 （31% ）, smoking 8 （25 % ）. Their clinical records were analysed to ascertain immediate and long term outcomes of ULMCA stenting. Results：The procedure success rate was 100 %, 48 drug - eluting stents was implanted, including ostia lesions 13 cases（40.6 % ）, body lessions 9 cases（28.1% ）, bifurcation lesions 10 cases（31.3% ）. The mortality is 3. 1% during hospitalization. MACE rate, TVR rate and stentthrombosis rate wasl 2.5 %, 9.4 % and 0 % respectively after （ 14.76 ± 8.46） months fllowed - up. Conclusion： Percutaneous coronary revascularization for unprotected left main coronary artery disease is feasible and safe, also has good short and long term effects.

关 键 词：介入治疗 冠状动脉 左主干病变 不良心脏事件 

分 类 号：R541.31[医药卫生—心血管疾病]