静息心率对冠脉慢性闭塞冠脉介入术血管再通率的影响

目的：了解静息心率（RHR）与冠状动脉慢性完全闭塞（CCT0）病变经皮冠状动脉介入术（PCT）成功率的关系。方法：人选2002年1月1日至2008年12月1日在我院及桂林医学院附属医院接受支架植人术的CCTO患者85例，根据入院时静息心率（RHR）分为RHR1（〈70次／min）、RHR2（70～79次／min）、RHR3（80～89次／min）和RHR4（≥90次／min）四组，比较不同组间血管即刻开通率。结果：76％（65／85）的患者成功完成了冠状动脉内支架植人术，4组血管即刻开通率分别是，RHR1：90％（18／20），RHR2：91％（20／22）。RHR3：63％（12／19），RHR4：63％（15／24），4组间有显著性差异（x^2=9．058，P〈0．05）；RHR1与RHR2，RHR3与RHR4间无显著差异（P均〉0．05），但RHR1与RHR3，RHR1和RHR4，RHR2与RHR3，RHR2与RHR4间有显著差异（P均〈O．05），RHRl和RHR2组的即刻开通率显著高于RHR3和RHR4组（P〈0．05）。结论：静息心率对冠状动脉慢性完全闭塞病变经皮冠状动脉介入术成功率有影响，静息心率越低手术成功率越高。

Effect of resting heart rate on repatency rate in patients with coronary chronic total occlusion

Objective： To study the relationship between resting heart rate （RHR） and repatency rate in patients with coronary chronic total occlusion （CCTO）. Methods： A total of 85 CCTO patients were treated by percutaneous coronary intervention （PCI） in our hospital and Guilin Medical College affiliated hospital. They were divided into four groups： group RHRI： 〈70 times/min, RHR2：70-79 times/min, RHR3：80-89 times/min and RHR4：≥90 times/min and its coronary repatency rate were compared. Results：Total success rate of PCI was 76% （65/85）. The coronary repatency rate of four groups was： RHR1： 90% （18/20）, RHR2： 91% （20/22）, RHR3： 63% （12/ 19）, RHR4 ： 63%（ 15 / 24）. The repatency rate between different groups were significantly difference （x^2= 9. 058, P=0. 029）. There was no significantly difference between RHR1 and RHR2 （x^2 =0.01, P=0. 920）, RHR3 and RHR4 （x^2=0.002, P=0.956）; there was significantly difference between RHR1 and RHR3 （x^2=3.955. P= 0.047）, RHRlandRHR4 （x^2=4.400, P=0.036）, RHR2 and RHR3 （x^2=4.589, P=0.032）, RHR2 and RHR4 （x^2=5.092, P=0.024）. Therepatency rate of RHRland RHR2 was higher than that of RHR3 and RHR4 （P〈0.05 all）. Conclusion： RHR can effecting the coronary repatency rate of PCI in patients with chronic total coronary occlusion, the more lower RHR, the more higher repatency rate.