SYNTAX评分中分区冠心病患者行不同再血管化治疗后的5年随访结果的比较  

Five-year follow-up outcomes after different revascularization treatment for coronary heart disease patients with moderate SYNTAX scores:a comparative study

作　　者：傅明炜 王热华[1] 郭延松[1] 陈威[1] FU Ming-wei;WANG Re-hua;GUO Yan-song;CHEN Wei(Department of Cardiology,Provincial Clinical College of Fujian Medical University&Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院暨福建省立医院心内科,福州市350001

出　　处：《广西医学》2020年第22期2918-2921,2938,共5页Guangxi Medical Journal

基　　金：福建省卫生厅青年科研课题(2012-2-7)。

摘　　要：目的比较SYNTAX评分中分区冠心病患者行经皮冠状动脉介入治疗(PCI)和冠状动脉旁路移植术(CABG)不同再血管化治疗后的5年随访结果。方法选取120例SYNTAX评分中分区(23~32分)的冠心病患者,根据血管重建方法分为PCI组64例和CABG组56例。以手术结束为观察起点,随访5年,观察主要终点[主要不良心脑血管事件(MACCE)]及次要终点(全因死亡、卒中、非致死性心梗、再次血运重建及前三者组成的次要复合终点)的发生情况。结果随访5年时,PCI组、CABG组的主要终点事件的发生率(分别为39.1%、28.6%)差异无统计学意义(P>0.05);PCI组、CABG组的全因死亡(分别为10.9%、8.9%)、卒中(分别为3.1%、7.1%)、非致死性心梗(分别为10.9%、5.4%)、再次血运重建(分别为14.1%、7.1%)、次要复合终点事件的发生率(分别为25.0%、21.4%)差异均无统计学意义(均P>0.05)。结论SYNTAX评分中分区冠心病患者行PCI或CABG术后5年时的MACCE(全因死亡、卒中、非致死性心梗及再次血运重建)的发生率相似。Objective To compare five-year follow-up outcomes of percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG)after different revascularization treatment for coronary heart disease(CHD)patients with moderate SYNTAX scores.Methods Totally 120 CHD patients with moderate SYNTAX scores(23-32 points)were selected,then were divided into PCI group(n=64)and CABG group(n=56)according to their revascularization methods.Five-year follow-up was performed with operative accomplishment as the start point of observation,then the incidence of primary outcome(major adverse cardiovascular and cerebrovascular events[MACCE])and secondary outcome(including all-cause mortality,stroke,non-fatal myocardial infarction,repeat revascularization or secondary composite endpoint consisting of the three aforementioned events)was observed.Results At the end of 5-year follow-up,no statistically significant difference was found between the PCI group and the CABG group in incidence rate of primary outcome events(39.1%vs.28.6%,P>0.05);no statistically significant difference was found between the PCI group and the CABG group in incidence rate of all-cause mortality(10.9%vs.8.9%),stroke(3.1%vs.7.1%),non-fatal myocardial infarction(10.9%vs.5.4%),repeat revascularization(14.1%vs.7.1%)or secondary composite endpoint events(25.0%vs.21.4%)(all P>0.05).Conclusion The CHD patients with moderate SYNTAX scores receiving PCI achieve similar incidence rates of MACCE(all-cause mortality,stroke,non-fatal myocardial infarction and repeat revascularization)at 5 years postoperatively as compared with those receiving CABG.

关 键 词：冠心病 SYNTAX评分 中分区 经皮冠状动脉介入治疗 冠状动脉旁路移植术 5年随访 主要不良心脑血管事件 主要终点 次要终点 

分 类 号：R541.4[医药卫生—心血管疾病]