冠状动脉慢性完全闭塞患者前向策略介入手术失败的预测研究  

Prediction of failure of forward strategy intervention in patients with chronic total coronary occlusion

作　　者：陈雅丽[1] 白雪洋[2] 王丽蕊[3] 闫佩佩[1] 肖莉丽[2] CHEN Yali;BAI Xueyang;WANG Lirui;YAN Peipei;XIAO Lili(Department Comprehensive Section I,the first affiliated Hospital of Zhengzhou university,Zhengzhou 45000,China)

机构地区：[1]郑州大学第一附属医院综合一科,450000 [2]郑州大学第一附属医院心血管内科,450000 [3]郑州大学第一附属医院重症医学科,450000

出　　处：《心肺血管病杂志》2022年第4期359-364,共6页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:研究冠状动脉慢性完全闭塞(CTO)患者前向策略介入手术失败的预测方法及其预测效能。方法:选取2018年9月至2020年7月,在我院拟实施介入手术的CTO患者212例,均于术前检查心电图碎裂QRS情况,并采用基于冠状动脉计算机断层扫描血管造影的日本多中心CTO注册中心(CT-J-CTO)标准进行评分。分析探讨影响CTO患者介入手术失败的因素和心电图碎裂QRS、CT-J-CTO评分预测CTO患者前向策略介入手术失败的价值。结果:CTO患者中,前向策略介入手术成功率为88.7%,介入手术失败率为11.3%;失败组心电图碎裂QRS发生率、CT-J-CTO评分均高于成功组(P<0.05);冠状动脉闭塞段≥20mm、存在心电图碎裂QRS、CT-J-CTO评分升高均是CTO患者介入手术失败的危险因素(P<0.05),侧枝循环>1级是其保护因素(P<0.05);心电图碎裂QRS、CT-J-CTO评分联合预测CTO患者介入手术失败的特异度均高于单独预测(P<0.05),灵敏度与单独预测比较差异均无统计学意义(P>0.05)。结论:心电图碎裂QRS联合CT-J-CTO预测CTO患者前向策略介入手术失败的效能高。Objective:To study the predictive method and predictive efficiency of failure of forward strategy intervention in patients with chronic total occlusion of coronary(CTO)artery.Methods:212 patients with CTO scheduled for interventional operation in our hospital from September 2018 to July 2020 were selected,and their ECG fragmented QRS were checked before operation,and the score was scored by the Japanese multi center CTO Registry(CT-J-CTO)based on coronary computed tomography angiography.The factors influencing the failure of forward strategy intervention in CTO patients and the predictive value of electrocardiogram fragmented QRS,CT-J-CTO score in predicting the failure of forward strategy intervention in CTO patients were analyzed.Results:In CTO patients,the success rate of interventional operation was 88.7%,and the failure rate of interventional operation was 11.32%.The incidence of electrocardiogram fragmented QRS,CT-J-CTO score in failure group were higher than those in success group(P<0.05).Coronary artery occlusion≥20 mm,presence of electrocardiogram fragmented QRS,CT-J-CTO score were risk factors for failure of intervention in CTO patients(P<0.05),and collateral circulation>grade 1 was protective factor(P<0.05).The specificity of electrocardiogram fragmented QRS,CT-J-CTO score in predicting the failure of forward strategy intervention in CTO patients were higher than those of single prediction(P<0.05).There was no significant difference in the sensitivity between the combination and single prediction(P>0.05).Conclusions:ECG fragmentation QRS combined with CT-J-CTO is highly effective in predicting the failure of forward strategy intervention in CTO patients.

关 键 词：碎裂QRS CT-J-CTO评分 心电图 冠状动脉慢性完全闭塞 介入手术 

分 类 号：R54[医药卫生—心血管疾病]