冠心病患者介入治疗后病变特点与远期预后的关系  

Relationship between characteristics of target coronary artery lesions and the prognosis of patients after standard 12-month dual antiplatelet therapy and coronary artery angioplasty

作　　者：李全[1] 玉献鹏[1] 潘昱[1] 赵华[1] 李宇[1] 杨帮国 张晓玲[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029

出　　处：《心肺血管病杂志》2016年第9期696-699,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：首都医学发展科研基金资助项目(项目编号:2009-2074);北京市医院管理局临床医学发展专项经费资助(项目编号:XMLX201406);首都卫生发展专项项目(2014-1-4016)

摘　　要：目的：探讨冠心病患者置入药物洗脱支架术（PCI）后的其靶病变特点与患者远期预后的关系。方法：回顾性分析2006年9月至2009年6月间,在北京安贞医院住院治疗并符合纳入标准的493例冠心病患者。根据支架置入的冠状动脉病变特点,定义复杂冠状动脉病变组和简单冠状动脉病变组。主要研究终点为PCI术后一年以上的远期不良事件的复合终点（包括全因死亡、非致死性心肌梗死、支架血栓、再次血运重建和脑卒中）。结果：493例冠心病患者中复杂冠状动脉病变组229例,简单病变组264例。通过Cox比例风险模型分析患者的远期预后,单因素研究显示复杂病变是远期主要终点不良事件的危险因素[HR=2.946,95%CI：1.14-7.60,P=0.025]。调整其他混杂因素后,显示该因素独立于其他危险因素,仍然是不良事件的危险因素[HR=2.836,95%CI：1.08-7.45,P=0.034],Kaplan-Meier曲线显示同样的结果。结论：冠心病患者的远期不良预后与置入药物洗脱支架的靶冠状动脉病变特点具有一定相关性。Objective：To analyze the association between characteristics of target coronary artery lesions and the long term prognosis of patients with drug-eluting stents （DESs） implantation. Methods： A total of suitable 493 patients were retrospectively analyzed who were reeeived DESs between September 2006 and June 2009. According to the eharaeteristies of eoronary artery which was implanted stents, all the patients were divided into two groups, which was complex group and simple group. The primary endpoint was a composite of all-eause death, nonfatal myocardial infarction （MI） , stent thrombosis, unexpected repeat revaseularization, and stroke. Results： The complex group eonsisted of 229 subjects and the simple group eonsisted of 264 subjeets. The complex group was assoeiated with an inereased ineidenee of primary endpoints [ HR = 2. 946, 95% CI： 1.14-7. 60 ,P =0. 025 ]. After adjustment of muhivariable COX regression, the eomplex group was still associated with an increased incidence of primary endpoints [ HR = 2. 836, 95% （21：1.08-7.45, P = 0. 034 ]. The Kaplan-Meier curve demonstrated the same trend. Conclusion： The long term prognosis of patients with DESs implantation was associated with characteristics of target coronary artery lesions.

关 键 词：冠心病 双联抗血小板 预后 

分 类 号：R54[医药卫生—心血管疾病]