冠心病多支血管病变部分血运重建优化药物治疗后非干预血管病变冠状动脉造影随访  

CAG follow-up of non intervention vascular lesions by optimizing medical therapy to the multivessel coronary artery disease

作　　者：王智[1] 唐强[1] 刘坤[1] 曲华清[1] 颜东[1] 陈学智[1] 唐群中[1] 史震涛[1] 刘秀敏[1] 

机构地区：[1]北京大学首钢医院心内科,100144

出　　处：《中国介入心脏病学杂志》2013年第2期93-96,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的研究冠心病多支血管病变(multivessel coronary artery disease,MVD)部分血运重建后优化药物治疗(optimizing drug therapy,OMT)对非干预血管病变的临床意义。方法对于256例冠心病多支血管病变患者进行部分血运重建(incomplete coronary revascularization,IR)+标准优化药物治疗1年后通过定量冠状动脉造影分析(quantitative coronary angiography,QCA),对未干预血管病变最小血管直径(the minimal luminal diameter,MLD)及血管直径狭窄率进行对比。结果 256例部分血运重建患者非干预血管病变QCA结果显示,临床指标达标患者190例,其中182例(95.8%)患者未干预血管病变MLD及直径狭窄率较前减轻或无变化,8例(4.2%)患者未干预血管病变MLD及直径狭窄率较前加重。临床指标未达标患者66例,其中56例(84.8%)患者未干预血管病变MLD及直径狭窄率较前减轻或无变化,10例(15.2%)患者未干预血管病变MLD及直径狭窄率较前加重。临床指标达标患者总有效性明显高于未达标患者(95.8%对84.8%,χ2=7.375,P<0.05),总无效性明显低于未达标患者(4.2%比15.2%,χ2=7.375,P<0.05)。结论冠心病多支血管病变部分血运重建患者优化药物治疗对于未干预血管病变具有明显临床意义。Objective To study the clinical significance of incomplete coronary revascularization （IR） and optimizing medical therapy （OMT） to the vascular lesions without intervention in multivessel coronary artery disease （MVD）. Methods 256 MVD patients were given IR and OMT. The degree of stenosis of non intervention lesions are compared by quantitative coronary angiography （QCA） one year later. Results Total 190 patients achieved the clinical targets of OMT. Among them, there were 182 patients showing no change or improvement in degree of the highest mininmal diameter （MLD） and stenosis rate while 8 patients showed decrease in MLD and increase in stenosis rate requiring revascularization. 66 patients did not meet the clinical targets of OMT. Among them, 56 patients showed no change or improvent in MLD and stenosis rate of non intervention vascular lesions and 10 patients showed decreased MLD and increased stenosis rate undergoing revascularization. The total effective ratio of OMT in patients meeting clinical targets was 95.8% compared to 84. 8% in patients who failed （ P 〈 0.05 ） . The total non effectiveness ratio is 4. 2% vs. 15.2% （P 〈 0. 05）. Conclusions There is obvious clinical significance of OMT to the non-intervention vascular lesions of MVD patients with IR.

关 键 词：冠心病 心肌血管重建术 药物疗法 冠状血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病]