稳定型心绞痛药物治疗与介入治疗对比

目的比较药物保守治疗和介入治疗稳定型心绞痛的效果。方法对136例稳定型心绞痛患者进行随访研究,按治疗方法不同分为药物治疗组(78例)和介入治疗组(58例),随访两组患者心脏事件发生率、再住院率、生存率、心功能情况及不良事件发生率。结果随访1年时药物组和介入组心脏事件发生率分别为7.7%和5.2%,再住院率分别为14.1%和6.9%,差异均无统计学意义(均P>0.05);随访3年时药物组和介入组心脏事件发生率分别为9.0%和6.9%,再住院率分别为15.4%和10.3%,生存率分别是98.7%和100%,差异也均无统计学意义(均P>0.05);经过治疗后介入组心功能改善和药物组相比差异无统计学意义(P>0.05),而介入组心绞痛复发率和再次血管重建术较药物组相比明显减少,差异均有统计学意义(P<0.05)。结论介入治疗和药物治疗对稳定型心绞痛患者的远期心脏事件发生率、减少再住院率、改善心功能、提高生存率都无明显差异。而介入治疗较药物治疗可明显降低稳定型心绞痛患者的心绞痛复发率、再次血管重建的发生率及不良事件总发生率。

Comparison of effects of drug treatment and percutaneous coronary intervention for stable angina pectoris

Objective To compare long-term effects of percutaneous coronary intervention(PCI)and medical therapy in patients with stable angina pectoris(SAP).MethodsA total of 136 patients with SAP were divided into two groups:Medical therapy(MT group,78 patients with optimal medicine treatment) and PCI group(58 patients with optimal medicine treatment and PCI).Major adverse cardiac events(MACE),Second in-hospital rate,survival rate and left ventricular ejection fraction(LVEF) were analyzed and compared.ResultsMACE rate in MT group and PCI group in the first year follow-up was 7.7% and 5.2% separately,re-admission rate was 14.1%and 6.9%;MACE rate with drug or PCI in 3 year follow-up was 9.0% and 6.9%;re-admission rate was 15.4%and 10.3%;3 years survival rate in MT group and PCI group was 98.7%and 100%.There was no difference in LVEF in both groups(P>0.05).After treatment,recurrence rate and vascular reconstruction of the PCI patients reduced significantly compared with that of MT patients(P<0.05).ConclusionsThere is no significant difference in MACE and Second in-hospital rate between MT group and PCI group of patients with SAP.Compared with drug therapy,PCI can significantly reduce the recurrence rate and revascularization rate in patients with stable angina pectoris.