冠状动脉多支病变不完全血运重建的疗效探讨

目的 探讨不完全性血运重建术对冠状动脉多支病变患者疗效及预后的影响.方法 113例经冠状动脉造影确诊为冠状动脉多支病变患者行单纯药物治疗(CT)或不完全血运重建治疗(IR),随访12个月,比较两组的左心室射血分数(LVEF)及心绞痛发作、6 min步行试验改善情况,以及再入院率、主要不良心血管事件(MACE)发生率、病死率.结果 治疗后,IR组6 ain步行试验(384.5±97.5)m]、LVEF(0.50士0.08)、心绞痛发作次数(4.1±2.3)次/周]较治疗前分别为(362.1±98.0)m、0.47±0.08、(6.4±2.1)次/周]显著改善(P值均＜0.01);CT组6 min步行试验(326.9±94.6)m]、LVEF(0.43±0.07)较治疗前(359.2±99.8)m、0.46±0.09]显著恶化(P值均＜0.01),治疗前心绞痛发作次数(7.0±2.9)次/周]与治疗后(6.1±1.8)次/周]的差异无统计学意义(P=0.053).随访12个月时,IR组6 min步行试验、LVEF的增幅分别为(0.08±0.03)%、(0.07±0.01)%,心绞痛发作次数降幅为(0.33±0.06)%;CT组6 min步行试验、LVEF值、心绞痛发作次数降幅分别为(0.08±0.02)%、(0.06±0.02)%、(0.05±0.05)%;两组间上述指标的差异均有统计学意义(P值均＜0.01).IR组再人院率为40.0%,显著低于CT组的60.4%(P＜0.05).IR组的MACE发生率及全因病死率分别为11:7%、3.3%,与CT组(分别为18.9%、3.8%)的差异均无统计学意义(P值均＞0.05).结论 冠状动脉多支病变行不完全性血运重建能够改善患者症状,提高生活质量,但对于预后的影响还需进一步研究.

Therapeutic effect of incomplete revascularization on patients with multivessel coronary artery disease

Objective To investigate the effect of incomplete revascularization on patients with multivessel coronary artery disease. Methods One hundred and thirteen patients with multivessel coronary artery disease were divided into 2 groups. One group received pure drug treatment (conservative treatment, CT) and the other group underwent incomplete revascularization with PCI (incomplete revascularization, IR). All patients were followed up for 12 months; the left ventricular ejection fraction (LVEF), number of angin...