经皮冠状动脉旋磨术在重度钙化病变介入治疗中的疗效及安全性  

Short-term efficacy and safety of percutaneous coronary rotational atherectomy with percutaneous coronary intervention for severe coronary calcification :a retrospective study

作　　者：饶宠佑 魏钟海[1] 谢峻[1] 王昆[1] 张静梅[1] 王涟[1] 徐标[1] 宋杰[1] 

机构地区：[1]南京医科大学鼓楼临床医学院心血管内科,江苏南京210008

出　　处：《南京医科大学学报（自然科学版）》2015年第4期534-537,541,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省卫生厅重点项目(H201436)

摘　　要：目的 ：研究经皮冠状动脉旋磨术（percutaneous coronary rotational atherectomy,PTCRA）联合冠状动脉介入治疗的短期临床疗效及安全性;方法：选择行冠脉造影检查证实为重度钙化并行经皮冠状动脉介入治疗的患者共112例,依据是否行PTCRA分为旋磨组及非旋磨组,观察围手术期并发症及术后9~12个月死亡和主要不良心血管事件（the major adverse cardiovascular events,MACE）发生率。结果：两组患者年龄、性别、高血压、吸烟史、糖尿病、胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、估计的肾小球滤过率（e GFR）、心脏射血分数（EF）等比较差异无统计学意义（P〉0.05）。两组患者术后9~12个月死亡及MACE发生率的差异无统计学意义（P〉0.05）,旋磨组围手术期并发症发生率较非旋磨组下降（P〈0.05）。结论：经皮冠状动脉旋磨术联合冠状动脉介入治疗能够有效地减少围手术期手术并发症,是治疗复杂性、钙化性病变安全有效的方法,并且有较好的短期临床疗效。Objective：To study the short-term clinical efficacy and safety in patients undergoing percutaneous coronary rotational atherectomy or percutaneous coronary intervention for severe coronary calcification. Methods： A total of 112 patients with coronary artery intervention treatment that confirmed as severe calcification by coronary angiography were divided into the PTCRA group and the non-VI＇CRA group. The perioperative complications,mortality and occurrence rates of the major adverse cardiovascular events （MACE） were collected postoperative 9-12 months. Results： There was no statistical difference（P 〉 0.05） between the two groups on age,sex,hypertension,smoking,diabetes,cholesterol,high-density lipoprotein cholesterol （HDL-c）,low density lipoprotein cholesterol （LDL-c） ,triglycerides, eGFR,heart ejection fraction （EF）,and other factors. The mortality and occurrence rates of MACE between the two groups had no statistical difference （P 〉 0.05）：and the PTCRA group had less complications than the non-PTCRA group （P 〈 0.05）. Conclusion： Percutaneous coronary rotational atherectomy with percutaneous coronary intervention can effectively reduce perioperative complications. The treatment for complexity, calcified lesions is safe and effective, and has a good short-term clinical efficacy.

关 键 词：冠状动脉钙化 经皮冠状动脉旋磨术 冠状动脉介入治疗 

分 类 号：R543.3[医药卫生—心血管疾病]