左主干病变合并慢性肾脏病患者血运重建术的长期预后  

Long-term prognosis of patients with left main coronary artery disease and chronic kidney disease after revascularization

作　　者：玉献鹏[1] 王伟军 吴长燕[1] 李宇[1] 何继强[1] 曾勇 YU Xianpeng;ZENG Yong;WU Changyan;LI Yu;HE Jiqiang(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029 [2]聊城市退役军人医院心内科

出　　处：《心肺血管病杂志》2022年第2期126-130,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨左主干病变合并慢性肾脏病(CKD)患者血运重建术的预后。方法:入选北京安贞医院行经皮冠状动脉介入术(PCI)或者冠状动脉旁路移植术(CABG)治疗的无保护左主干病变合并慢性肾脏病患者240例,其中PCI组121例,CABG组119例。研究终点为全因死亡、心肌梗死、卒中、再次血运重建。结果:随访时间中位数6.1(5.1,8.0)年,两组全因死亡发生率(PCI 29.8%vs. CABG 34.5%)、心源性死亡率(PCI 24.0%vs. CABG 21.8%)和心肌梗死发生率(PCI 15.7%vs. CABG 10.9%)两组间差异无统计学意义。PCI组卒中发生率显著低于CABG组(1.7%vs. 14.3%, P<0.05),PCI组再次血运重建发生率显著高于CABG组(24.8%vs.15.1%P=0.002)。结论:左主干病变合并CKD血运重建术的预后较差,PCI和CABG全因死亡和心肌梗死发生率相当,PCI组卒中发生率显著低于CABG而再次血运重建高于CABG。Objective: To evaluate the long-term prognosis of patients with left main coronary artery disease and chronic kidney disease(CKD) after revascularization. Method: 240 patients with lesions in unprotected left main coronary artery and CKD were enrolled who underwent percutaneous coronary intervention(PCI) or coronary artery bypass grafting(CABG) in Beijing An Zhen Hospital(PCI n =121;CABG n =119). The endpoint of the study was death, MI, stroke and repeat revascularization. Results: The median follow-up was 6.1(5.1,8.0) years in the overall patients. There were no significant differences in occurrences of death(PCI 29.8% vs. CABG 34.5%), cardiac death(PCI 24.0% vs. CABG 21.8%) and MI(PCI 15.7% vs. CABG 10.9%). The unadjusted and adjusted results both showed P>0.05. The occurrence of stroke was significantly higher in the CABG group(PCI 1.7% vs. CABG 14.3%, P<0.05). The occurrence of repeatrevascularization was significantly higher in the PCI group(PCI 24.8% vs. CABG 15.1%, P=0.002). Conclusions: The prognosis of patients with left main coronary artery disease and CKD after revascularization was poor. The were no significantly differences between PCI and CABG in the occurrences of death and MI. PCI had significantly higher rate of revascularization but lower rate of stroke compared with CABG.

关 键 词：左主干病变 预后 慢性肾脏病 

分 类 号：R54[医药卫生—心血管疾病]