冠状动脉旁路移植术后再发心绞痛患者原位经皮冠状动脉介入治疗与优化药物治疗的对比  

Comparison of native vessel percutaneous coronary intervention and optimal drug therapy in patients with recurrent angina pectoris after coronary artery bypass grafting

作　　者：陈海坚[1] 莫逆[1] 朱秀龙[1] 曹勇[2] 魏芝宝[1] 陈炎[1] 苏国柱 Chen Haitian Mo Ni Zhu Xiulong Cao Yong Wei Zhibao Chen Yan Su Guozhu(Department of Cardiology, Gaozhou People＇s Hospital of Guangdong Province, Guangdong Gaozhou 525200, Chin)

机构地区：[1]广东省高州市人民医院心血管内科,525200 [2]广东省高州市人民医院心血管外科,525200

出　　处：《中国医师进修杂志》2017年第9期807-810,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨冠状动脉旁路移植术（CABG）术后再发心绞痛患者原位经皮冠状动脉介入治疗（NV-PCI）与优化药物治疗（ODT）的疗效比较.方法 回顾性分析142例CABG术后再发心绞痛行冠状动脉造影检查患者的临床资料,其中行NV-PCI 70例（NV-PCI组）,行ODT 72例（ODT组）.比较两组主要不良心血管事件（MACE）发生率和左心室射血分数（LVEF）.结果 所有患者均随访至少1年.ODT组与NV-PCI组桥血管数目和闭塞桥血管数目比较差异无统计学意义[（2.5±0.7）支/例比（2.4±0.9）支/例和（1.4±0.9）支/例比（1.3±0.7）支/例,P〉0.05].NV-PCI组MACE发生率明显低于ODT组[12.9％（9/70）比22.2％（16/72）],LVEF明显高于ODT组[（63.5±14.0）％比（57.1±9.0）％],差异有统计学意义（P〈0.05）.结论 CABG术后再发心绞痛患者NV-PCI与ODT相比,MACE发生率明显降低,而LVEF明显提高.Objective To compare the efficacy of native vessel percutaneous coronary intervention （NV-PCI） and optimal drug therapy （ODT） in patients with recurrent angina after coronary artery bypass grafting （CABG）. Methods The clinical data of 142 recurrent angina pectoris after CABG patients who had underwent coronary angiography were retrospectively analyzed. Among the patients, 70 cases were treated with NV-PCI （NV-PCI group）, and 72 cases were treated with ODT （ODT group）. The incidence of major adverse coronary events （MACE） and left ventricular ejection fraction （LVEF） were compared between 2 groups. Results All patients were followed up for at least 1 years. There were no statistical differences in the number of bypass vessels and number of occluded vessels between ODT group and NV-PCI group： （2.5 ± 0.7） branches/case vs. （2.4 ± 0.9） branches/case and （1.4 ± 0.9） branches/case vs. （1.3 ± 0.7） branches/case, P〉0.05. The incidence of MACE in NV-PCI group was significantly lower than that in ODT group： 12.9％ （9/70） vs. 22.2％ （16/72）, and the LVEF was significantly higher than that in ODT group：（63.5 ± 14.0）％vs. （57.1 ± 9.0）％, and there were statistical differences （P〈0.05）. Conclusions Compared with the ODT, the NV-PCI has lower incidence of MACE and higher LVEF in patients with recurrent angina pectoris after CABG.

关 键 词：心绞痛 药物疗法 冠状动脉旁路移植术 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]