经皮激光心肌血运重建术治疗心绞痛的临床疗效观察  

Clincal Efficacy of Percutaneous Laser Myocardial Revascularization on Treatment of Angina Pectoris

作　　者：陶军[1] 廖新学[1] 杨惜泉[1] 王礼春[1] 唐安丽[1] 马虹[1] Vieeca M 

机构地区：[1]中山医科大学附属第一医院心内科,广东广州510080 [2]意大利米兰大学附属心血管内科

出　　处：《中山医科大学学报》2002年第2期121-123,共3页Academic Journal of Sun Yat-sen University of Medical Sciences

基　　金：教育部科学基金资助项目 ( 2 0 0 0 479)

摘　　要：【目的】观察经皮激光打孔心肌血运重建术治疗顽固性心绞痛的临床疗效。【方法】应用经皮激光 (HO :YAGlaser)心内膜心肌打孔治疗 2 7例顽固性心绞痛患者 ,以加拿大心绞痛标准分级和Naughton运动试验ST段下移至 1mm所需时间作为激光心肌血运重建术疗效的临床观察指标。【结果】每例打孔 5～ 15个 ,平均 (8± 4)个。打孔前和打孔后 1月、3月、6月按加拿大心绞痛标准分级 ,分别为 (3 5± 0 5 )、(2 2± 0 8)、(2 0± 0 6 )、(2 1± 0 5 )级 ;Naughton运动试验ST段下移至1mm所需时间则分别为 (36 0± 16 0 )s、(4 0 6± 2 6 0 )s、(4 2 0± 2 90 )s、(4 5 0± 312 )s。【结论】经皮激光打孔心肌血运重建术能降低患者心绞痛的严重程度 ,对不能常规施行经皮冠状动脉腔内成形术 (PTCA)或冠状动脉旁路搭桥术 (CABG)的严重冠心病心绞痛的患者 ,经皮激光心肌血运重建术是一种有效治疗方法。Objective To observe the clinical efficacy of percutaneous laser myocardial revascularization (PLMR) on the treatment of angina pectoris. Methods Twenty-seven patients with refractory angina pectoris were treated by percutaneous myocardial revascularization with holmium: YAG laser. The angina pectoris class of Canadian Cardiovascular Society (CCS) and time to 1-mm ST segment depression induced by Naughton exercise test were used as the clinical observational indexes of PLMR treatment. Results The number of channels created by PLMR were from 5 to 15 with an average of 8±4. The mean CCS angina class before PLMR was 3.5±0.5 and fell to 2.2±0.8 at 1-month, to 2.0±0.6 at 3-month and to 2.1±0.5 at 6-month after PLMR, respectively. Time to 1 mm ST segment depression was (360±160) s before PLMR, (406±260) s at 1-month and (420±290) s at 3-month and (450±312) s at 6-month after PLMR, respectively. Conclusion The present clinical observation demonstrates that PLMR can effectively reduce the severity of angina pectoris and can be used as an efficient alternative therapeutic method for patients with refractory angina pectoris untreatable by PTCA and CABG.

关 键 词：冠状动脉疾病 心绞痛 心肌血管重建术 激光 治疗 疗效观察 

分 类 号：R541.4[医药卫生—心血管疾病] R654.2[医药卫生—内科学]