观察导丝技术结合经皮冠状动脉介入术对冠状动脉慢性完全闭塞的疗效  

Curative effect of“guard wire”combined with PCI on coronoary chronic total occlusion

作　　者：周彬[1] 王晓纲[1] Zhou Bin;Wang Xiaogang(No.2 Department of Cardiology,Xingtai People's Hospital,Xingtai 054000,Hebei Province,China)

机构地区：[1]邢台市人民医院心脏内二科,054000

出　　处：《中华老年心脑血管病杂志》2021年第12期1272-1275,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：邢台市科技计划项目(2019ZC265)。

摘　　要：目的研究"门卫"导丝结合PCI对冠状动脉慢性完全闭塞(CTO)的近远期疗效及对心肌重构、内皮损伤的影响。方法选取我院2017年6月~2019年8月收治的186例常规PCI的CTO患者,按照数字随机表法分为对照组93例和观察组93例(采用"门卫"导丝结合PCI)。治疗前后测量硝酸甘油介导的非内皮依赖性舒张功能(NMD)以及血流介导的血管舒张功能(FMD),并用彩色心脏超声测量左心室壁厚度(LVWT)、左心室舒张期末内径(LVEDD)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV),计算LVEF。随访1年,记录主要不良心血管事件(MACE)。比较2组相关指标差异。结果观察组PCI总时间、X线曝光时间及造影剂用量明显低于对照组(P=0.000),PCI成功率明显高于对照组(90.32%vs 79.57%,P=0.040)。观察组治疗后LVEF高于对照组,LVESV、LVEDV、LVWT、LVEDD、NMD以及FMD低于对照组(P<0.05)。观察组MACE发生率明显低于对照组(4.30%vs 12.90%,P=0.036)。结论 "门卫"导丝技术可提高PCI成功率,降低MACE。Objective To study the short-and long-term curative effects of"guard wire"combined with PCI on coronary CTO,and its effect on myocardial remodeling(MR) and endothelial injury(EI).Methods One hundred and eighty-six patients with coronary CTO admitted to our hospital were divided into control group(n=93) and observation group(n=93).The patients in control group underwent conventional PCI and those in observation group received combined"guard wire"and PCI.The NMD,FMD,LVWT,LVEDD,LVESV,and LVEDV were measured, the LVEF was recorded before and after treatment respectively.The patients were followed up for 1 year, during which the MACE were recorded.The short-and long-term curative effects of combined"guard wire"and PCI on coronoary CTO,MR and EI were compared between the two groups.Results The total PCI time and X-ray exposure time were significantly shorter(P=0.000) while the PCI success rate was significantly higher in observation group than in control group(90.32% vs 79.57%,P=0.040).The LVEF was significantly higher while the LVESV and LVEDV were significantly smaller, the LVWT was significantly thinner, the LVEDD,NMD and FMD were significantly shorter in observation group than in control group(P<0.05).The incidence of MACE was significantly lower in observation group than in control group(4.30% vs 12.90%,P=0.036).Conclusion "Guard wire" technique can improve the finger PCI success rate and reduce the incidence of MACE,and is thus worthy of popularization in clinical pratice.

关 键 词：经皮冠状动脉介入治疗 冠状动脉闭塞 内皮 血管 动脉粥样硬化 

分 类 号：R543.3[医药卫生—心血管疾病]