分期介入治疗颈动脉狭窄合并冠心病的临床疗效及随访效果观察  

Study on the efficacy and follow- up results of staged interventional therapy in treatment of coexistent stenosis of carotid artery and coronary artery disease

作　　者：肖淑英[1] 杜会山[1] 孟繁花[1] 封靖[1] 耿晓坤[1] 童燕娜[1] 程哲[1] 

机构地区：[1]首都医科大学附属北京潞河医院神经内科,北京101149

出　　处：《临床和实验医学杂志》2017年第4期363-367,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨分期介入治疗颈动脉狭窄合并冠心病的临床疗效及随访效果。方法选取2008年10月至2012年10月期间收治的78例颈动脉狭窄合并冠心病患者,随机分为观察组和对照组,每组39例,两组患者均行经皮冠状动脉介入(PCI)治疗和颈动脉支架术(CAS),观察组患者行分期介入治疗,对照组患者行同期介入治疗。对比观察两组患者的治疗效果、并发症以及随访效果。结果观察组的临床治疗总有效率(97.4%)明显高于对照组(79.5%),差异有统计学意义(P<0.05);观察组治疗过程中的总并发症发生率(10.3%)明显低于对照组(38.5%),差异有统计学意义(P<0.05)。手术后进行长期随访发现,观察组患者支架内狭窄、血管闭塞、心肌梗死以及脑梗死的发生率(0,0,2.6%,5.1%)明显低于对照组(7.7%,10.3%,12.8%,17.9%),差异均有显著性(P<0.05)。两组患者的肾功能术前术后比较差异均无统计学意义(P>0.05),且组间比较术前术后差异也无统计学意义(P>0.05)。结论对于颈动脉狭窄合并冠心病患者,分期先行PCI术后再行CAS术治疗,不仅疗效显著,合并症发生率低,且同时长期随访效果好,安全可靠,是临床上一种安全有效的治疗方式。Objective To explore the efficacy and follow- up results of staged interventional therapy in treatment of coexistent carotid artery stenosis and coronary artery disease. Methods A total of 78 patients with coexistent carotid artery stenosis and coronary artery disease were treated in this hospital during October 2008 to October 2012. These patients were randomly divided into observation group and control group,with39 cases in each group. All patients were given with carotid artery stenting（ CAS） and percutaneous coronary intervention（ PCI）,patients in control group were given with simultaneous hybrid interventional therapy,while the patients in observation group were given with staged interventional therapy. The therapeutic effects,complications and results of follow- up were compared between these two groups. Results After operation,the total clinical efficacy of observation group was 97. 4%,and it was 79. 5% in control group,and the difference was significant（ P〈0. 05）. The incidence of complications in control group was 38. 5%,while it was 10. 3% in observation group,and it was significantly lower than that of control group（ P〈0. 05）. After long- term follow- up,the incidence and probability of in- stent stenosis,vascular occlusion and myocardial infarction in observation group were all significantly lower than those of control group（ P〈0. 05）. The renal function of patients in these two groups had no obvious change before and after surgery（ P〈0. 05）,and the difference between these two groups was not statistically significant too（ P〉0. 05）. Conclusion By using staged interventional therapy in treatment of patients with coexistent carotid artery stenosis and coronary artery disease can raise its efficacy,reduce the incidence of complications and improve the follow- up result. Hence it is a safe and clinically effective therapeutic regimen.

关 键 词：颈动脉狭窄 冠心病 分期介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病] R543.4[医药卫生—内科学]