冠状动脉介入治疗时代孤立性左主干狭窄病变患者的临床特征和预后分析  

Clinical characteristics and prognosis of patients with isolated left main stenosis in coronary intervention

作　　者：周靖[1] 戴允浪 Zhou Jing;Dai Yunlang(Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China)

机构地区：[1]苏州大学附属第一医院心血管内科,江苏苏州215006

出　　处：《临床荟萃》2021年第1期12-15,共4页Clinical Focus

基　　金：江苏省自然科学基金资助项目经皮冠状动脉介入治疗无保护左主干病变患者的预后(201727273)。

摘　　要：目的回顾性分析孤立性左主干(left main coronary artery,LMCA)狭窄病变患者的临床特征和预后。方法连续入选30例孤立性LMCA狭窄病变患者并分为两组:开口病变组(n=21)和非开口病变组(n=9)。随访终点为主要心脑血管不良事件(major adverse cardiac or cerebrovascular event,MACCE),其定义为全因死亡及需住院的心脑血管事件。结果30例孤立性LMCA病变患者大部分接受了经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗(25/30,83.3%),仅有2例接受冠状动脉旁路移植术,余3例仅接受了药物治疗。在中位37.0个月的随访期间内,MACCE发生率为23.3%(7/30),其中包括死亡4例。与非开口病变组相比,开口病变组女性患者更多(47.6%vs 0%,P=0.013),年龄更小(57.8±10.9岁vs 66.0±7.8岁,P=0.050),MACCE发生率明显更低(9.5%vs 55.6%,P=0.014)。结论PCI治疗孤立性LMCA狭窄病变是一种有效、安全的治疗方法,且开口病变组较非开口病变组远期MACCE发生率低。Objective The clinical features and prognosis of patients with isolated left main coronary artery(LMCA)were analyzed retrospectively.Methods Thirty consecutive patients with isolated LMCA stenosis were selected and divided into two groups:open lesion group(n=21)and non-open lesion group(n=9).The follow-up endpoint was major adverse cardiac or cerebrovascular event(MACCE),which was defined as all-cause death and cardiovascular and cerebrovascular events requiring hospitalization.Results Most of the 30 patients with isolated LMCA were treated with percutaneous coronary intervention(PCI)(25/30,83.3%),only 2 patients received coronary artery bypass grafting,and the remaining 3 patients only received medication.During the median follow-up period of 37.0 months,the incidence of MACCE was 23.3%(7/30),including 4 deaths.Compared with non-open lesion group,open lesion group had more female patients(47.6%vs 0%,P=0.013),younger age(57.8±10.9 vs 66.0±7.8,P=0.050),and significantly lower MACCE incidence(9.5%vs 55.6%,P=0.014).Conclusion PCI is an effective and safe treatment for isolated LMCA stenosis,and the long-term MACCE incidence in open lesion group was lower than that in non-open lesion group.

关 键 词：冠状动脉狭窄 左主干狭窄 冠状动脉介入治疗 预后 

分 类 号：R543.3[医药卫生—心血管疾病]