全军第三次(2003～2004年)冠心病介入治疗注册登记资料分析

目的分析2003-2004年全军冠心病介入治疗（PCI）的整体情况和发展趋势。方法2005年4月向全军所属医院发出PCI注册登记表，根据表格提供的资料对2003-2004年全军完成的PCI病例进行回顾性统计分析。结果共收到61家军队医院16842例的PCI病例注册资料，其中2003年7052例，2004年9790例。共处理冠状动脉病变23706处，其中单纯球囊扩张1632处（6．9％），其余22074处（93．1％）植入了支架；植入药物洗脱支架8086枚（占支架总数的36．6％）。PCI病例总成功率97．7％（16449／16842），其中支架植入成功率99．8％。主要院内PCI并发症和不良心脏事件发生率4．2％（708／16842），包括急性闭塞0．3％、亚急性闭塞0．4％、心包填塞0．1％、支架脱落0．1％、急诊冠状动脉旁路移植术0．1％、院内死亡1．2％（包括急性心肌梗死病例）等。随访中靶血管再血管化5．1％。共完成急性心肌梗死急诊PCI 2467例，左主干PCI 576例，桥血管PCI 137例，经桡动脉PCI 3051例，慢性完全闭塞病变PCI 2124处，均较前次注册资料有大幅增加。平均每年完成PCI≤100例的医院占57．3％，≥200例的医院占13．2％，2家医院年例数在1000例以上。结论近2年全军医院PCI技术以每年完成例数增加40％左右的速度迅速发展，但不同医院之间还存在较大差异，发展不够平衡，今后需要继续加强技术培训和协作。

Analysis of the third (from 2003 to 2004) PLA coronary intervention therapy registry

Objective To analyze the status and trend of the development of percutaneous coronary intervention (PCI) in Chinese military hospitals from 2003 to 2004. Methods In April 2005, a registry form was dispatched to all army hospitals, and items in regard of PCI during 2003 to 2004 were asked to be filled for analysis. Results From 2003 to 2004, a total of 16842 cases of PCI performed in 61 PLA hospitals (7052 in 2003, 9790 in 2004) were registered and reported. The intervention procedures were performed in a total of 23706 target lesions, of which only 1632 target lesions (6.9%) were dilated by balloon, and 22074 target lesions (93.1%) were implanted with coronary stents, and 8086 stents among all were drug eluted (36.6% of all stents), including 4270 eluted with rapamycin (Cypher and Firebird, 52.8%), 2072 Paclitaxel eluted (25.6%) and 1744 eluted with other kinds of drug (21.6%). Total success rate of PCI was 97.7% (16449/16842), and success rate was 99.8% in patients with stented procedure. The incidence of major complications and major adverse cardiovascular events was 4.2% (708/16842), including acute occlusion of coronary artery (0.3%), subacute occlusion (0.4%), pericardial tamponade (0.1%), falling of stent (0.1%), emergency coronary artery bypass grafting (0.1%), an inhospital mortality of 1.2% (including death resulted in acute myocardial infarction), and slow-flow or no-flow (1.6%). During follow-up period, target vessel revascularization was done in 5.1% of the patients. Emergency PCI for acute myocardial infarction was performed in 2467 cases, PCI for left main coronary artery and grafted vessel was performed in 576 cases and 137 cases, respectively. Trans-radial PCI was done in 3051 cases. 2124 PCI were done for chronic total occlusion lesions, and the number increased tremendously compared with the last registry. In 57.3% of the hospitals enrolled in the registry, the annual PCI number was less than 100 cases, while in 13.2% of the hospitals the annual number of PCI was over 200 cases, and in only 2 hospitals the annual PCI number was over 1000 cases. Conclusions The annual case numbers of PCI in PLA hospitals within the recent two years increased by around 40% every year. The success rates for complicated lesions, the use of new technique, and the complication rate of PCI were comparable with that reported in domestic and foreign literature published in recent years. It is noted that, the development has been quite different among different hospitals, so that technical training and cooperation should be emphasized in the future.