不同治疗方法对冠心病合并射血分数中间值的心力衰竭患者预后的影响  

Effects of Different Treatment Methods on the Prognosis of Patients with Coronary Heart Disease Combined with Heart Failure with Midrange Ejection Fraction

作　　者：史慧婷 郭晨然 李亚彭[1] 吴磊明 张彦周[1] SHI Huiting;GUO Chenran;LI Yapeng;WU Leiming;ZHANG Yanzhou(Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院心内科,河南郑州450000

出　　处：《河南医学研究》2021年第7期1166-1173,共8页Henan Medical Research

摘　　要：目的比较不同治疗方法对冠心病(CHD)合并射血分数中间值的心力衰竭(HFmrEF)患者预后的影响。方法回顾性分析2018年1—12月就诊于郑州大学第一附属医院155例CHD合并HFmrEF患者的病历资料,其中128例患者接受经皮冠脉介入术(PCI)治疗,27例患者接受单纯药物治疗。其中接受PCI治疗的患者根据PCI术后是否完全血运重建分为完全血运重建组(73例)和不完全血运重建组(55例)。通过郑州大学第一附属医院住院病历电子系统收集各组患者入院期间临床症状、冠状动脉造影(CAG)、心脏多普勒彩色超声、血清学指标及基础用药情况,比较各组患者治疗1 a后主要心血管不良事件(MACE)发生情况及心功能指标。结果3组一般资料比较,差异无统计学意义(P>0.05)。治疗1 a后,3组MACE发生率、再发心绞痛行PCI治疗发生率、再次入院次数两两比较,差异有统计学意义(P<0.05),且均为单纯药物治疗组最高,不完全血运重建组次之,完全血运重建组最低。3组非致死性心肌梗死发生率、靶血管重建发生率比较,差异有统计学意义(P<0.05),单纯药物治疗组非致死性心肌梗死发生率、靶血管重建发生率均高于完全血运重建组和不完全血运重建组(P<0.05),而完全血运重建组与不完全血运重建组组间比较,差异无统计学意义(P>0.05)。治疗1 a后,完全血运重建组和不完全血运重建组新发狭窄发生率比较,差异有统计学意义(P<0.05)。治疗1 a后,3组NT-proBNP均较治疗前下降,且3组间比较,差异有统计学意义(P<0.05),组间两两比较,差异有统计学意义(P<0.05),其中完全血运重建组最低,不完全血运重建组次之,单纯药物治疗组最高。治疗1 a后,3组LVEF、FS、6分钟步行试验距离均较治疗前升高(P<0.05),3组LVEF及6分钟步行试验距离比较,差异有统计学意义(P<0.05),其中完全血运重建组水平最高,不完全血运重建组次之,单纯药物治疗组最低。�Objective To compare the effects of different treatment methods on the prognosis of patients with coronary heart disease(CHD)combined with heart failure with midrange ejection fraction(HFmrEF).Methods The medical records of 155 patients with CHD combined with HFmrEF admitted to the First Affiliated Hospital of Zhengzhou University from January to December 2018 were retrospectively analyzed,and 128 patients received percutaneous coronary intervention(PCI)treatment,and 27 patients received medication alone.The patients receiving PCI were divided into complete revascularization group(73 cases)and incomplete revascularization group(55 cases)according to whether complete revascularization was achieved after PCI or not.The clinical symptoms,coronary angiography(CAG),cardiac Doppler color ultrasound,serological indicators and basic medication were collected by the electronic system of inpatient medical record of the First Affiliated Hospital of Zhengzhou University.Major adverse cardiovascular events(MACE)and cardiac function indexes in each group were compared after one year of treatment.Results There were no statistical differences in general information among the three groups(P>0.05).After one year of treatment,there were statistical differences in the incidences of MACE,incidences of recurrent angina pectoris treated by PCI and times of readmission among the three groups(P<0.05).The incidences of MACE,incidences of recurrent angina pectoris treated by PCI and times of readmission in medication alone group were the highest,and those in incomplete revascularization group were the second,and those in complete revascularization group were the lowest.There were statistical differences in the incidences of non fatal myocardial infarction and target vessel reconstruction among the three groups(P<0.05).The incidences of non fatal myocardial infarction and target vessel reconstruction in medication alone group were all higher than those in complete revascularization group and incomplete revascularization group(P<0.05).There

关 键 词：冠心病 射血分数中间值的心力衰竭 经皮冠脉介入术 预后 

分 类 号：R541.4[医药卫生—心血管疾病]