碘克沙醇对单支及多支血管病变患者冠状动脉介入治疗临床预后研究  

Prognosis of patients with single-vessel and multi-vessel coronary intervention treated with iodoxacol

作　　者：隋洪刚 王效增 杨霖 赵昕 顾若曦 韩雅玲 SUI Hong-gang;WANG Xiao-zeng;YANG Lin;ZHAO Xin;GU Ruo-xi;HAN Ya-ling(Postgraduate Training Base of General Hospital of Northern Theater Command,Jinzhou Medical University,Shenyang 110016,China)

机构地区：[1]锦州医科大学北部战区总医院研究生培养基地,辽宁沈阳110016 [2]北部战区总医院心血管内科,辽宁沈阳110016

出　　处：《临床军医杂志》2019年第10期1084-1086,1090,共4页Clinical Journal of Medical Officers

基　　金：辽宁省科技计划项目(2013225089)

摘　　要：目的探讨碘克沙醇对单支及多支血管病变患者行经皮冠状动脉介入治疗(PCI)的主要不良心脑血管事件(MACCE)及对比剂诱发的急性肾功能损伤(CI-AKI)差异。方法选取自2013年10月至2015年10月中国30个中心入选的3 042例行冠状动脉支架植入术患者为研究对象。根据病变血管支数不同将患者分为单支病变(SV)组(n=2 618)与多支病变(MV)组(n=424)。主要研究终点为PCI术后72 h MACCE[包括靶病变再次血运重建(TLR)、卒中、支架内血栓、心源性死亡、非致死性心肌梗死(MI)]及CI-AKI,次要终点为PCI后72 h至30 d的MACCE发生情况。记录并比较两组患者终点事件发生率。结果SV组患者PCI手术时间、水化总体积、碘克沙醇用药时间、碘克沙醇体积低于MV组,术后水化比例、术前及术后均水化比例高于MV组,两组比较比较,差异均有统计意义(P<0.05)。两组患者病变血管、病变分级、术前心肌梗塞溶栓血流比较,差异有统计学意义(P<0.05)。两组患者主要终点事件比较:SV组MACCE、MI发生率低于MV组,两组比较,差异有统计学意义(P<0.05)。两组患者次要终点比较:SV组TLR发生率、支架内血栓发生率低于MV组,两组比较,差异有统计学意义(P<0.05)。结论应用碘克沙醇行PCI治疗后,MV患者住院期间的MACCE及MI发生率较SV患者增加,CI-AKI发生率无差异;术后72 h至30 d MV患者TLR及支架内血栓风险增加。Objective To investigate the difference between the main adverse cardiovascular and cerebrovascular events(MACCE)and contrast-induced acute kidney injury(CI-AKI)in Chinese patients with single-vessel(SV)and multi-vessel(MV)coronary artery lesion after percutaneous coronary intervention(PCI).Methods A retrospective study was performed on 3 042 cases of patients who underwent coronary stent implantation from October 2013 to October 2015.Patients were divided into the SV group(n=2 618)and MV group(n=424)according to the number of diseased vessels.The primary endpoint was MACCE 72 hours after PCI[including target lesion reascularization(TLR),stroke,stent thrombosis,cardiac death,non-fatal myocardial infarction(MI)]and CI-AKI,and the secondary endpoint was MACCE 72 hours to 30 days after PCI.The incidence of end-point events was recorded and compared between the two groups.Results The PCI operation time,total hydration volume,iodoxanol administration time and iodoxanol volume of the SV group were less than those of the MV group.The postoperative hydration ratio,preoperative and postoperative hydration ratio of the SV group were higher than those of the MV group,and there was statistically significant difference between the two groups(P<0.05).There were statistically significant differences between the two groups in blood vessel lesion,lesion grade and thrombolytic blood flow in preoperative myocardial infarction(P<0.05).Comparison of main endpoint events between the two groups:the incidence of MACCE and MI in the SV group was lower than that in the MV group(P<0.05).Comparison of secondary endpoints between the two groups:the incidence of TLR and stent thrombosis in the SV group was lower than that in the MV group(P<0.05).Conclusion The incidence of MACCE and MI in MV patients during hospitalization was higher than that in SV patients after PCI treatment with iodoxacol,and there was no difference in the incidence of CI-AKI.Revascularization of target lesions and increased risk of stent thrombosis in MV patients 72 hour

关 键 词：经皮冠状动脉介入治疗 主要不良心脑血管事件 对比剂诱发的急性肾功能损伤 

分 类 号：R543[医药卫生—心血管疾病]