无保护左主干病变患者32例经皮冠状动脉介入治疗临床观察  

Clinical observation of percutaneous coronary intervention in 32 patients with unprotected left main coronary artery disease

作　　者：肖建强[1] 何国平[1] 李勇[1] 高磊[1] 施有为[1] 杨海涛[1] 周惠芬[1] 

机构地区：[1]常州市武进人民医院心血管内科,江苏常州213002

出　　处：《心脏杂志》2015年第2期161-164,共4页Chinese Heart Journal

摘　　要：目的：评估无保护左主干冠状动脉（UPLMCA）病变患者行经皮冠脉介入治疗（PCI）的安全性和有效性。方法：回顾分析2009年9月-2013年8月完成的32例行PCI治疗的UPLMCA病变患者的临床资料。结果：32例UPLMCA病变患者中非分叉病变11例,分叉病变21例;所有患者均接受了支架植入术,其中单支架23例,单支架＋球囊对吻5例,双支架4例;术中发生迷走反射和边支闭塞致小面积心肌梗死各1例,另1例（SYNTAX评分为37分）于PCI术后4 d死于支架内亚急性血栓形成;出院后随访5-51（22±13）个月,随访率100%,随访期间死亡1例（3%）、发现再狭窄后行靶血管重建3例（9%）;住院期间及随访期间总主要心脑血管不良事件发生率19%（6/32）。结论：经选择的UPLMCA病变患者行PCI安全可行,近、中期疗效良好。AIM： To evaluate the safety and efficacy of percutaneous coronary intervention（ PCI） for unprotected left main coronary artery（ UPLMCA） disease. METHODS： Clinical data of 32 patients with UPLMCA disease who received PCI from September 2009 to August 2013 were analyzed retrospectively.RESULTS： Of the 32 cases,there were 11 cases of non-bifurcation lesion and 21 cases of bifurcation lesion. Stent implantations were performed in all patients,including 23 cases of single stent,five cases of single stent plus kissing balloon and four cases of double stents. Intraoperative vagal reflex occurred in one case and side branch occlusion-induced small area myocardial infarction occurred in one case. One patient（ SYNTAX score 37） died from subacute stent thrombosis 4 days after PCI. All patients were followed up for 21. 53 ± 12. 89 months. Death occurred in one case（ 3. 13%） and target vascular remodeling because of stent restenosis in three cases（ 9. 38%） during the follow-up period. The total occurrence of major adverse cardiac and cerebrovascular events during hospitalization and follow-up periods was 18. 75%（ 6 /32）.CONCLUSION： PCI for selected patients with UPLMCA disease is safe and feasible and produces good short-and medium-term efficacy.

关 键 词：无保护左主干 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]