不同年龄段冠心病患者临床及冠状动脉病变特点

目的探讨不同年龄段冠心病(CHD)患者的临床及冠状动脉病变特点。方法275例CHD患者根据年龄分为青年组(<45岁)17例,中年组(45~60岁)83例,普通老年组(60~75岁)138例和高龄老年组(≥75岁)37例,对4组患者的临床特点、血生化指标及冠状动脉造影(CAG)结果进行比较分析。结果4组比较,随年龄增长吸烟比例逐渐降低(P<0.05),而高血压患病率逐渐升高(P<0.01);随年龄增长血尿酸水平逐渐升高(P<0.01)。CAG结果比较,青年组和中年组以单支病变为主,而普通老年组和高龄老年组以多支病变较多;普通老年组和高龄老年组左回旋支(LCX)和右冠状动脉(RCA)病变所占比例均明显多于青年组和中年组(P<0.05,P<0.01);普通老年组和高龄老年组ACC/AHA(美国心脏病学会和美国心脏病协会)积分和弥漫长病变所占比例明显高于中年组(P<0.01)。结论不同年龄段冠心病患者有不同的临床和冠状动脉病变特点,不同年龄人群应采取有针对性的冠心病防治措施;不同年龄人群冠脉病变血管部位不同,普通老年人和高龄老年人LCX和RCA病变所占比例较大。     

Myocardial infarction in young adults-risk factors and pattern of coronary artery involvement

Background:

Coronary artery disease (CAD) mostly occurs in persons older than 45 years of age. In India, CAD manifests almost a decade earlier than in Western countries. This study was done to study the risk factors and angiographic profile in young patients presenting with acute myocardial infarction (AMI).

Patients and Methods:

One hundred and twenty four consecutive patients presenting with AMI at less than 40 years of age were studied for risk factors. Coronary angiography was done in all.

Results:

Out of 124 patients, 123 were male. Mean age was 35.94 ± yrs. One hundred and eighteen had ST elevation myocardial infarction (MI) (95.16%) and six had non ST elevation MI (5.84%). Anterior wall MI was present in 88 patients (70.97%), inferior wall MI in 31 patients (25%) and lateral wall MI in five patients (4.03%). Seventy three patients (58.8%) were smoker, 55 were hypertensive (44.35%), 10 were diabetic (8.06%). Family history of CAD was present in 22 (17.7%) patients. Low High-density lipoprotein (HDL) was seen in 53 patients (42.7%), and high triglycerides in 60 patients (48.38%). Significant CAD was found in 88 (70.96%) patients, 13 (10.48%) had normal coronaries. Single vessel disease was seen in 57 patients, two-vessel disease in 15 patients and three-vessel disease in eight patients. Total 125 lesions were seen and left anterior descending (LAD) was the commonest vessel involved, with 78 lesions (62.4%).

Conclusion:

AMI in young almost exclusively occurs in male, and ST elevation MI is the main presentation. Anterior wall MI is most common, with LAD being involved in around 2/3 patients. Smoking, hypertension, low HDL and high triglycerides are the major risk factors.     

45岁以下女性冠心病患者患病危险因素和冠状动脉病变特点研究

目的探讨45岁以下青年女性冠心病患者危险因素和冠状动脉病变的特点。方法回顾性分析468例行冠状动脉造影的青年女性的临床资料,根据冠状动脉造影结果分为冠心病组和对照组。观察两组患者的吸烟史、高血压病、2型糖尿病、血脂异常等危险因素与冠心病发病的关系,分析冠心病组冠状动脉病变的特点。结果 (1)冠心病组高血压病、2型糖尿病、高胆固醇血症、低高密度脂蛋白胆固醇的发生率及超敏C反应蛋白水平明显高于对照组,差异均有统计学意义(P<0.05)。(2)Logistic回归分析显示,冠心病的独立相关危险因素依次为2型糖尿病、高血压病及超敏C反应蛋白(P<0.05)。(3)冠心病组单支血管病变者发生率高,为69.81%,且多为前降支,受累率为72.96%。结论 45岁以下女性冠心病患者的独立相关危险因素为2型糖尿病、高血压病及超敏C反应蛋白增高,病变多累及前降支。     

非动脉粥样硬化性冠状动脉病变的临床特点及2a随访

目的探讨非动脉粥样硬化性冠状动脉病变的临床特点及其2 a随访结果。方法回顾性总结967例18～45岁有冠状动脉病变的患者,从中最终筛选出24例非动脉粥样硬化的患者进行临床分析。结果 (1)24例(2.48%)患者男女之比为7∶5,平均年龄(41.62±2.68)岁。(2)女性与男性相比,起病至首诊时间长(男性首诊时间中位数为0.25个月,女性为7.50个月,P<0.05),初发心绞痛的发生率低(男性为42.86%,女性为0.00%,P<0.05),心肌梗死及节段性室壁运动异常发生率低(男性为50.00%,女性为10.00%,P<0.05),左心室舒张末期内径(LVEDD)小[男性为(51.83±7.51)mm,女性为(44.90±4.58)mm,P<0.05]。(3)18～40岁与41～45岁2个年龄段比较,病情特点相同。在41～45岁患者中,男性患者心肌梗死发生率高(男性为50.00%,女性为0.00%,P<0.05)、LVEDD扩大[男性为(51.56±5.05)mm,女性为(46.14±4.30)mm,P<0.05]。(4)冠状动脉病变以单支病变为主,其中左前降支病变占全部病例的50.00%。(5)24例患者行经皮冠状动脉介入治疗后均获得临床缓解。住院期间及2 a随访均无主要心血管不良事件发生。(6)3例患者在2 a随访中接受了风湿性疾病的筛查,其中2例诊断为系统性血管炎且病变处于稳定期。结论非动脉粥样硬化性冠状动脉病变在临床上并不罕见,多数在40岁左右发病。与传统冠状动脉粥样硬化性心脏病(简称冠心病)相比,女性患者相对比例提高;女性起病较隐匿,病情相对较轻;病情轻重与患者年龄无关;冠状动脉病变以单支病变为主。按照常规冠心病行药物、经皮冠状动脉介入治疗后短期疗效好。推测部分患者病因可能为系统性血管炎所致。对于怀疑有冠状动脉病变的中青年女性,建议排除非动脉粥样硬化性病变。     

1 069例冠心病患者冠状动脉造影与中医证候特点

目的：研究冠心病冠状动脉造影和中医证候特点。方法：用临床流行病学方法调查1069例冠心病患者,按发病年龄分青年组（82例,年龄≤45岁）和中老年组（987例,年龄〉45岁）,分析两组患者临床资料及冠状动脉病变和中医证候特点。结果：青年组男性比例、甘油三酯、总胆固醇、吸烟人数、发生急性心肌梗死比例和冠心病家族史显著高于中老年组（P〈0.05）。中老年组伴发高血压和糖尿病的病例高于青年组（P〈0.05）。中老年组冠脉造影检查,左主干、回旋支和多支病变的发病率显著高于青年组（P〈0.05）。青年组单支病变和双支病变的发病率显著高于中老年组（P〈0.05）。青年冠心病组中气滞、痰浊的比例显著高于中老年组（P〈0.05）,而中老年组的寒凝、阳虚、阴虚和肾虚的比例显著高于青年组（P〈0.05）。结论：青年冠心病心绞痛中医证候和冠脉病变有自身的特点而区别于老年冠心病。     

Clinical evaluation of 99mTc-MIBI myocardial tomography for detecting coronary artery disease.

To evaluate the clinical efficacy of 99mTc-MIBI myocardial tomography for detecting coronary artery disease, 34 consecutive patients who underwent both 99mTc-MIBI study and coronary arteriography were included in the present study. Ten without and 24 with significant coronary artery disease were documented by coronary arteriography. The overall sensitivity and specificity of 99mTc-MIBI study for detecting coronary artery disease were 91.8% (22/24) and 80.0% (8/10), respectively. In subset studies, 16 of 17 (94.1%) patients with previous myocardial infarction and 6 of 7 (85.7%) patients with significant CAD but without MI were identified as abnormal. Reversible perfusion abnormalities were shown in 4 of 5 patients undergoing both exercise and rest studies. Rest perfusion abnormalities were shown in 2 patients with unstable angina pectoris who underwent only rest study. In conclusion, 99mTc-MIBI myocardial tomography provides a reliable method for detecting coronary artery disease. Rest study has high sensitivity for identifying patients with MI, and exercise/rest study can identify patients with significant CAD but without MI.     

中青年与老年脑梗死患者脑动脉狭窄分布的 DSA 分析

目的：比较中青年与老年脑梗死患者脑动脉狭窄分布的数字减影血管造影（DSA）结果,分析脑动脉狭窄分布特征。方法：将我院收治的100例脑梗死患者,按照不同的年龄段,分成中青年组60例与老年组40例,均给予 DSA 检查,对两组患者的脑动脉病变血管狭窄发生率、狭窄程度、分布情况及发作部分等特征进行比较。结果：老年组患者的颅外动脉、前循环狭窄等部位病变发生率显著高于中青年组患者,而颅内动脉、后循环狭窄等部位病变则显著低于中青年组患者,差异存在统计学意义;两组患者的血管狭窄程度均以重度狭窄甚至闭塞为主,均显著高于同组内的轻度、中度狭窄发生率,差异有统计学意义,且主要的发作部位均为椎动脉开口,两组患者的椎动脉开口发生率均显著高于同组的大脑中动脉 MI 段、颈内动脉起始段等发生率,差异有统计学意义。结论：中青年脑梗死与老年脑梗死患者的脑动脉狭窄分布存在一定的差异,前者以颅内脑血管动脉病变为常见,后者则以颅外脑动脉血管病变为主,但均好发于椎动脉开口,且狭窄程度均为重度或闭塞。     

Comparison of 99mTc-methoxyisobutylisonitrile myocardial single-photon emission computed tomography and electron beam computed tomography for detecting coronary artery disease in patients with no myocardial infarction

Background Previous studies have compared single-photon emission computed tomography (SPECT) and electron beam computed tomography (EBCT) in detection of coronary artery disease (CAD) in patients with myocardial infarction (MI). The purpose of this study was to compare SPECT with EBCT in detection of CAD in patients with no MI.Methods One hundred and forty-seven patients with suspected CAD underwent stress-rest 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) myocardial SPECT, cardiac EBCT and coronary angiography (CAG) within one month. Of them, 73 patients (aged 52.6±10.6 years old) with no history of MI were included in this study. Coronary artery calcium (CAC) was defined as a CT value ≥130 HU within the boundary of coronary artery on EBCT. Results There were 35 and 38 patients with or without CAD according to CAG. Ninety-six percent of the patients with abnormal SPECT and CAC had a coronary arteries stenosis ≥50%, and 90.9% patients with normal SPECT and EBCT showed no CAD. The sensitivity of SPECT and EBCT in detection of CAD was comparable, and the specificity of SPECT (92.1%) was significantly higher than that of EBCT (55.3%) (P&lt;0.005). For the detection of individual coronary artery stenosis, both sensitivity and specificity of SPECT (75.0% and 93.7%) were significantly higher than those of EBCT (53.3% and 76.7%) (P&lt;0.025 and P&lt;0.005, respectively). In patients without chest pain, the sensitivity and specificity of SPECT (76.9% and 91.4%) were significantly higher than those of EBCT (23.1% and 69.0%) in detection of a coronary artery stenosis of ≥50% (P&lt;0.01 and P&lt;0.005, respectively). However, in patients with chest pain, both sensitivity and specificity of SPECT were comparable to those of EBCT. In patients ≤45 years old, the sensitivity of SPECT (77.8%) was significantly higher than that of EBCT (27.8%) in assessing a coronary artery stenosis of ≥50% (P&lt;0.005), and the specificity of SPECT was comparable to that of EBCT. In patients &gt;45 years old, the specificity of SPECT (94.3%) was significantly higher than that of EBCT (70.5%) (P&lt;0.005), and the sensitivity of SPECT was comparable to that of EBCT. Conclusion 99mTc-MIBI myocardial perfusion SPECT has higher accuracy than that of EBCT in detection of CAD in patients without MI.     

维吾尔族和汉族心肌梗死患者冠脉病变的临床研究

目的探讨汉族和维吾尔族心肌梗死(MI)患者危险因素和冠状动脉病变的差异。方法对汉族和维吾尔族临床诊断为MI且行选择性冠状动脉造影(CAG)检查阳性患者739例病例资料进行回顾性分析,其中汉族患者303例(占41.0%),维吾尔族436例(占59.0%);冠状动脉病变程度由病变部位、支数、分型及病变Gensini总积分表示。结果①两组冠脉病变累及血管依次为前降支(LAD)、右冠状动脉(RCA)、左回旋支(LCX)和左主干(LM);②两组患者随着年龄增长A型病变逐渐减少,C型病变逐渐增多;与汉族组比较,维吾尔族组LM病变、B型、C型病变率高(P<0.05);③汉族组MI发病年龄段主要集中在60岁以上,其中60~69岁年龄段占33.0%,维吾尔族组主要集中在50~59岁,占32.3%;④两组患者随着年龄增长,Gensini总积分逐渐增加,各年龄段维吾尔族组Gensini总积分均高于与汉族组(P<0.05)。结论维吾尔族MI患者冠脉病变程度随年龄增长而增加,单支病变逐渐减少,三支病变逐渐增加;维吾尔族MI患者冠脉病变程度较汉族患者重;维吾尔族MI患者发病年龄可能比汉族患者早。     

危险因素对青年和老年男性冠状动脉病变影响的分析

目的分析部分心血管危险因素对青年和老年男性冠状动脉病变的影响,以总结各自发病的特点及预防对策。方法分析213例行冠脉造影的住院患者,根据冠脉造影结果分为青年病例组和对照组、老年病例组和对照组。进行吸烟、饮酒、体重指数、血压、血脂、空腹血糖、尿酸等危险因素对比分析。结果青、老年病例组和对照组之间体重指数、血糖、舒张压水平和胆固醇水平差异无显著性(P>0.05)。饮酒率以青年病例组明显高于其他组;血压、吸烟率、冠脉病变评分以老年病例组高于其他组;青年病例组尿酸和脂蛋白(A)明显高于青年对照组;而老年组仅体现为脂蛋白(A)增高;青年组甘油三酯、低密度脂蛋白相应高于老年组;而高密度脂蛋白低于老年组。结论高尿酸血症、低密度脂蛋白增高和高密度脂蛋白降低是青年冠心病的主要特点,脂蛋白(A)是冠心病的危险因素之一,在青、老年之间不具有特异性;血压升高是老年人冠脉病变重要的影响因素。早期采取积极手段进行干预,可减少冠心病发病的危险因素,降低发病率。     

Effects of different therapies on coronary artery disease

Objective To analyse the effects of different therapies on coronary artery disease (CAD).Methods A total of 1055 patients who suffered from CAD diagnoised by coronary angiograpy were divided into three groups, namely pure drug therapy, percutanious coronary intervention (PCI) and coronary artery bypass graft (CABG) groups. Follow up was carried out from March to May in 2001, and the major adverse cardiac events (MACEs) including death, no-lethal myocardial infarction (Ml) and revascularization were observed. In long-term observation, angina reoccured, and their improvement was evaluated. The short-term period was defined as the duration of 30 days after discharge, and the long term period was defined as the duration from 30 days after discharge.Results In the long-term period, the recurrences of angina both in PCI group and CABG group were lower than pure drug group (PO. 018, 0. 002 respectively). No differences about long-term endpoint events were observed among these three groups ( P > 0. 05). Forty-t     

青年人急性心肌梗死危险因素与冠状动脉造影特点分析

目的探讨青年人急性心肌梗死(AMI)患者的危险因素与冠状动脉造影特点。方法分析临床确诊为AMI的54例青年组(<45岁)及108例老年组患者(≥60岁)的危险因素、临床特点及冠状动脉病变等,并进行比较。结果诱发因素:青年组76%(41/54),老年组22.2%(24/108),前者明显高于后者(P<0.01)。青年组中危险因素依次为吸烟史、家庭史及高血脂症;冠状动脉造影显示:青年组以单支病变为主,很少累及左主干,两组相比差异显著(P<0.01)。结论戒烟、降低血脂、规范青年人冠心病的二级预防,有助于预防青年人AMI的过早发生。     

VALUE OF ANGINA PECTORIS AFTER MYOCARDIAL INFARCTION IN PREDICTING EXTENT OF CORONARY ARTERY DISEASE

Clinical , hemodynamic, and angiographic data were examined in 53 patients who underwent catheterization within 6 months of documented acute transmural myocardial infarction (MI). The patients were divided into two groups on the basis of presence (23 patients ,group I) or absence (30 patients. Group II ) of angina pectoris 1 month after MI. Group I patients had more severe coronary artery disease and a greater prevalence of multivessel disease than group II patients. Partial preservation of segmental left ventricular wall function in group I was related to the presence of collateral vessels. In patients with single vessel disease , incidence of spontaneous recanalization of the infarct – related artery was mote common in group I as compared with those in group II .It is concluded that angina pectoris after MI suggests multivessel disease or infarct – related artery recanalization .Coronary angiography may be advised in these patients in order to select adequate therapeutic interventions and improve prognosis.     

年轻人吸烟方式对急性心肌梗死临床特征的影响

目的：评价年轻人吸烟方式对急性心肌梗死（AMI）临床特征的影响。方法选择2000-06—2013-06入院2周内行冠状动脉造影的年轻AMI患者112例（观察组）,年龄≤45岁;连续选取2011-01—2012-11收治的50～70岁AMI患者112例作为对照组。记录患者心血管危险因素（吸烟史、高胆固醇血症、高血压、糖尿病和心血管家族史）和临床特征（心绞痛史、射血分数、住院病死率以及冠状动脉造影结果）并进行分析。结果观察组患者有吸烟史者高达84.8%,明显高于对照组患者（P＜0.01）,而对照组最大的危险因素是高血压（P＜0.01）;两组吸烟指数差异无统计学意义（P＞0.05）,但观察组每天吸烟量明显大于对照组（P＜0.01）。观察组胸痛＜12h比例高于对照组（均P＜0.01）。观察组累计冠状动脉狭窄积分较对照组低（P＜0.05）;观察组旋支为罪犯血管的发生率较对照组低（P＜0.01）,1支血管病变比例较对照组高（P＜0.01）,3支血管病变比例较对照组低（P＜0.01）。结论年轻人AMI临床心绞痛病史短,冠状动脉硬化程度轻,病变血管多数以单支血管病变为主,以旋支为罪犯血管极少见。而年轻人长期大量的吸烟方式是影响其AMI临床特征的最主要危险因素。     

不同年龄段急性心肌梗死患者介入治疗的预后分析

目的：探讨不同年龄段急性心肌梗死患者介入治疗的预后。方法：选取行介入治疗的急性心肌梗死患者120例,按照不同年龄段分为中青年组（<60岁）和老年组（≥60岁）各60例,对其预后进行回顾性分析。结果：两组患者介入治疗前梗死相关动脉（前降支、回旋支、右冠状动脉）分布比较,差异无统计学意义。老年组患者多支冠脉病变发生率明显高于中青年组患者,差异具有统计学意义。中青年组手术并发症,住院天数及心功能恢复情况均优于老年组,差异具有统计学意义;中青年组住院期间心血管事件发生率与老年组比较,差异无统计学意义。中青年组术后1年MACE发生率明显低于老年组,差异具有统计学意义;中青年组病死率和老年组比较,差异无统计学意义。结论：年龄是影响急性心肌梗死介入治疗预后的危险因素,中青年急性心肌梗死患者预后优于老年急性心肌梗死患者。对于老年急性心肌梗死患者应及时进行介入治疗,采取有效治疗措施,同样也能有利于预后恢复。     

青年男性冠心病的危险因素及Framingham风险评分的预测价值

目的 探讨青年男性冠状动脉粥样硬化性心脏病(以下简称冠心病)的危险因素及Framingham风险评分的预测价值.方法 选取2016年7月至2019年7月期间在首都医科大学附属北京地坛医院行冠状动脉造影术的201例青年男性患者作为研究对象(30≤年龄<45岁),按照冠状动脉造影结果分为冠心病病例组(n=139)和非冠心病...     

中青年急性冠状动脉综合征危险因素及介入治疗临床分析

目的分析中青年急性冠状动脉综合征(ACS)的危险因素及经皮冠状动脉介入治疗(PCI)情况,指导临床防治。方法对中青年组(<55岁)32例和老年组(≥70岁)31例ACS病人的危险因素及冠状动脉造影(CAG)、PCI、随访结果等进行分析。结果危险因素居首位的中青年组是吸烟(68.75%),老年组则为高血压史(74.19%)。中青年组吸烟、饮酒、高LCL-C血症患者较老年组多,有高血压、冠心病史的患者少,两组差异有统计学意义(P<0.05)。冠状动脉造影显示狭窄病变中青年组前降支累及最多(81.25%),单支病变的比例较老年组(34.38%vs16.13%)高,但闭塞性、弥漫性病变例数两组无显著差异(P>0.05);中青年组右冠状动脉病变达56.25%,多支病变(21.88%)较老年组(80.65%、48.39%)少,直接PCI的例数(31.25%vs9.68%)多,两组有显著差异(P<0.05)。术中、术后并发症及随访结果两组无显著差异。结论中青年ACS的主要危险因素与不良生活习惯相关,吸烟居首位;冠状动脉病变范围和程度已与老年ACS患者差别不大,直接PCI安全且效果好。     

中国与澳大利亚心肌梗死患者冠状动脉病变特点的比较研究

目的：比较中国和澳大利亚部分心肌梗死（MI）患者心血管病危险因素和冠状动脉造影（CAG）结果的差异。方法：对中澳两国临床诊断MI的977例患者行选择性CAG检查，并对年龄、性别和CAG结果进行对比分析。结果：中国组CAG阳性（直径狭窄50％以上）550例，占95．16％，澳大利亚组CAG阳性376例，占94．24％，中国和澳大利亚MI患者比较，〈40岁患者2．08％vs6．02％（P〈0．05），男性患者85．6％vs79．7％（P=0．015），高血压、高脂血症患者分别为58．65％vs28．57％和11．59％vs68．42％（P〈0．01），糖尿病患者为17．30％傩16．29％（P〉0．05），3支病变及完全闭塞病变分别为32．87％vs24．31％和45．50％vs32．33％（P〈0．01），两组冠状动脉（CA）病变累及的血管，均依次为左前降支（LAD）、右冠状动脉（RCA）、左回旋支（LCX）和左冠状动脉主干（LM）。中国MI患者70—79岁年龄段发病率最高，为29．58％，澳大利亚人发病年龄段主要集中在50—59岁，为32．08％。结论：与澳大利亚人相比较，中国MI患者年轻人较少，高血压发生率高，高脂血症发生率低，CA病变中以多支病变及完全闭塞更为多见。     

青年卒中与中老年卒中的病因分型及危险因素比较

目的：比较青年卒中和中老年卒中患者的病因分型及危险因素。方法：回顾性收集首都医科大学中国康复研究中心神经康复科住院青年卒中（18～45岁）患者100例的病历资料,并随机抽取同期住院的中老年卒中（45岁及以上）患者100例,进行入院时一般情况统计（年龄、性别、出血性/缺血性、瘫痪部位）及既往病史、个人史。结果：两组的主要病因均为大动脉粥样硬化性卒中（分别为31例,30.7%; 51例,50.5%）,青年组其它原因卒中（5例,5%）及不明原因卒中（2例,2%）均高于中老年组（0例,0%;0例,0%）。而青年组小动脉闭塞性卒中(1例,1%)及心源性卒中（2例,2%）均低于中老年组（3例,3%;6例,5.9%）。结论：青年组的主要危险因素依次为：高血压、饮酒、吸烟、高脂血症、高同型半胱氨酸血症、糖尿病、既往卒中病史。青年组高同型半胱氨酸血症的发病率高于中老年组,高血压、糖尿病、冠心病等发病率中老年组高于青年组。     

体外与非体外循环下冠状动脉搭桥治疗冠状动脉三支病变的对比研究

目的:对比研究体外与非体外循环下冠状动脉搭桥治疗冠状动脉三支病变的临床效果。方法:300例单纯冠状动脉多支搭桥患者分别进入常规体外循环下冠状动脉搭桥组(CCABG组,n=150例)和非体外循环冠状动脉搭桥组(OPCAB组,n=150例)。两组患者在心绞痛程度、合并慢性阻塞性肺病(COPD)、心肌梗死史和糖尿病、急诊手术和左主干(LM)病变等方面无显著性差异,但OPCAB组手术前有脑梗死史和肾功能异常患者的比例明显多于CCABG组(P均<0.05)。所有患者均采用胸骨正中切口。CCABG组在常规CPB心脏停跳下进行,OPCAB组用单根心包深吊线,引入一纱条,帮助暴露各冠状动脉分支,采用心脏局部固定器,辅以腔内分流栓,完成远端吻合。所有患者术终行桥血流定量测定。结果:OPCAB组无1例需转成CCABG。所有患者均在心脏侧壁和后壁区域搭桥。两组人均冠状动脉远端吻合数(OPCAB组:3.84±1.06,CCABG组:3.75±0.94)和再血管化指数相似;手术后呼吸支持时间、胸腔引流量和输血量OPCAB组明显少于CCABG组(P<0.05,P<0.01);OPCAB组呼吸功能不全和肾功能异常发生率低于CCABG(P均<0.05);两组围手术期心肌梗死、脑卒中、房颤发生率和手术病死率无统计学差异。结论:对比研究结果显示,OPCAB可用于冠状动脉三支血管病变,能达到与常规CCABG相似的完全性再血