2006年、2011年中国城市医院经桡动脉冠状动脉介入治疗情况分析——China PEACE回顾性CathPCI研究结果  

Transradial Percutaneous Coronary Intervention at Urban Hospitals of China in 2006 and 2011——Results from China PEACE-Retrospective CathPCI Study

作　　者：郑昕[1] 胡爽[1] 王秀玲[1] 王斌[1] 李希[1] 李静[1] 蒋立新[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院国家心血管病临床研究中心心血管疾病国家重点实验室中国牛津国际医学研究中心,北京市100037

出　　处：《中国循环杂志》2017年第6期542-546,共5页Chinese Circulation Journal

基　　金：国家卫生和计划生育委员会卫生公益性行业科研专项(201202025;201502009);国家科技部科技支撑计划(2015BAI12B01;2015BAI12B02);高等学校学科创新引智计划(B16005)

摘　　要：目的:分析2006年、2011年中国城市医院经桡动脉经皮冠状动脉介入治疗(PCI)患者的临床特征、治疗模式和院内结局的变化。方法:使用"冠心病医疗结果评价和临床转化研究"——回顾性冠状动脉(冠脉)造影和PCI研究(China PEACE回顾性Cath PCI研究)的数据,分析两阶段随机抽样获得的2006年和2011年有代表性的城市医院行经桡动脉PCI患者的临床信息,并对每年度的数据分别进行加权计算。结果:来自53家医院的3 301例病例纳入分析。2006~2011年5年间经桡动脉PCI的住院患者数增加7倍。与2006年相比,2011年患者女性比例和平均年龄有所增高(P均<0.05);到院时合并肾功能不全[估计肾小球滤过率<60 ml/(min·1.73 m2)]和心力衰竭者有所减少(P均<0.05);冠脉病变呈单支病变者减少,而三支病变和左主干病变者增多(P均<0.01)。2006~2011年间,PCI干预病变的部位分布无明显变化;药物洗脱支架的使用率呈显著增高(P<0.001),2011年为97.7%;抗栓和他汀类药物的使用率普遍显著增加。2006年、2011年患者住院时长分别为1(07,15)天和11(7,14)天(P>0.05)。与2006年相比,2011年穿刺部位出血的发生率显著下降(P<0.01),其余院内不良事件均无显著变化。结论:2006~2011年间,我国城市医院行经桡动脉PCI手术量迅猛增加,患者临床特征和治疗模式均发生了显著变化,我国经桡动脉介入治疗技术日趋成熟和常规化。Objective： To analyze the clinical features, treatment and outcomes for in-hospital patients undergoing transradial percutaneous coronary intervention （PCI） at urban hospitals of China in the year of 2006 and 2011. Methods： Using the information of China PEACE-retrospective CathPCI study, we conducted with 2-stage, random sampling strategy by investigating the data of Chinese urban hospital representative patients undergoing transradial PCI in 2006, 2011 and performed the weighting calculation for clinical data in each year. Results： A total of 3301 patients from 53 hospitals were enrolled. During 5 years from 2006 to 2011, the in-hospital patients of transradial PCI were increased 7 folds. Compared with 2006, 2011 had more female patients with the elder mean age,P〈0.05; less patients with renal dysfunction as estimated glomerular filtration rate〈60ml/（min·1.73m2） and less heart failure （HF） at admission,P〈0.05; less patients with coronary single vessel disease and more with three vessel disease, P〈0.01. From 2006 to 2011, no obvious changes were found in PCI treated lesions by location and distribution; the usage of＆nbsp;drug eluting stents （DES） was increased,P〈0.001 and DES application rate was 97.7% in 2011; the application rates of anti-thrombus and statins were significantly increased. The length of hospital stay was 10 （7, 15） days in 2006 and in 11 （7, 14） days in 2011,P〉0.05. Compared with 2006, there were less bleeding events at puncture site in 2001,P〈0.01; while the in-hospital adverse events were similar between 2 years. Conclusion： Application of transradial PCI was rapidly increasing at urban hospitals of China from 2006 to 2011, the clinical features and treatment had been changing; the technique becoming mature and popularized.

关 键 词：冠状动脉疾病 血管成形术 经腔 经皮冠状动脉 桡动脉 

分 类 号：R541.4[医药卫生—心血管疾病]