年轻患者行冠状动脉旁路移植手术与介入治疗的中远期临床对比观察  

The comparison of mid and long term outcomes of coronary artery bypass grafting versus percutaneous coronary intervention in youg patients with three-vessel disease

作　　者：郭鹏飞[1] 王嵘[1] 肖苍松[1] 汪成[1] 申磊磊 高长青[1] 

机构地区：[1]解放军总医院/解放军医学院心血管外科,北京100853

出　　处：《中国体外循环杂志》2016年第2期103-107,共5页Chinese Journal of Extracorporeal Circulation

摘　　要：目的对比评价45岁以下冠状动脉硬化性心脏病(冠心病)三支病变患者接受冠状动脉旁路移植手术(CABG)与经皮介入支架植入术(PCI)两种再血管化方式治疗患者的预后。方法选取2000年1月至2015年1月在本院心血管外科行CABG的45岁以下三支病变冠心病患者58例(CABG组),同期在心内科行PCI治疗的45岁以下三支病变患者(PCI组)与CABG组按照1∶1的比例配对。对比两组患者的围术期情况,随访观察两组患者生存率、心脑血管不良事件(MACCE)免除率、桥血管及支架内通畅率,比较分析年轻早发冠心病患者采用两种再血管化治疗方式的近中远期预后情况。评价两种治疗方式的效果。结果 CABG组与PCI组的围术期死亡率、并发症发生率差异无统计学意义(P>0.05)。术后中远期生存率两组差异无统计学意义(P>0.05)。但CABG组患者的重复再血管化免除率、桥血管/支架内通畅率和MACCE事件免除率明显高于PCI组(P<0.05)。结论对于三支病变的年轻患者,CABG和PCI均是安全有效的治疗方式。但CABG的中远期预后优于PCI治疗。Objective To observe and analyze the outcomes of coronary artery bypass grafting（CABG） and percutaneous coro-nary intervention（PCI） in patients with three-vessel disease aged ≤ 45 years.Methods We assembled 58 patients with three-vesseldisease aged ≤ 45 received Coronary Artery BypassGrafting between January 2000 and January 2015 in our cardiovascular surgery de-partment as the CABG group. meanwhile we matched 58 patients who received Percutaneous Coronary Intervention during the corre-sponding period as PCI group by 1：1 rate. By observing the situations before and after the operation and following up the mid and longterm survival rate, free from MACCE rate, patency rate between two groups. We analyzed the short mid and long term outcomes be-tween two revascularization methods treating young patients with premature coronary heart disease. To evaluate the curative effect of tworevascularization methods.Results The perioperative mortality and incidence of complications were similar（P〉0.05） between twogroups. There was no statistic difference in mid and long term survival rate of two groups（P〉0.05）. But CABG group has a higher freefrom repeat revascularization rate, patency rate and free from MACCE rate than the PCI group（P〈0.05）.Conclusion Young pa-tients with three-vessel disease, both Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention are safty and effectivemethods. But CABG had a better mid and long term outcomes than PCI.

关 键 词：年轻 冠状动脉旁路移植术 经皮介入支架植入术 生存率 再血管化 通畅率 

分 类 号：R654.2[医药卫生—外科学]