左主干病变不同治疗方法的疗效分析

目的　观察不同治疗方法对冠心病左主干病变患者的近期或远期疗效的影响。方法　对我院 1993年至 1998年期间的 10 5 5例冠心病患者分别进行药物治疗、经皮冠状动脉介入术 (PCI)或冠状动脉旁路移植术 (CABG)治疗 ,于 2 0 0 1年 3至 5月对上述患者进行随访 ,平均随访时间 (3 16±1 2 8)年。观察终点包括死亡、非致死性心肌梗死以及再次行心肌血运重建术 (PCI和CABG)。其中左主干病变为 4 2例 ,男 31例 (79 2 % ) ,女 11例。结果　 4 2例左主干病变采用PCI的占 16 6 7% ,CABG占 38 10 % ,药物治疗占 4 5 2 3%。PCI和CABG两组 (n =2 3) ,随访结果均无死亡和心肌梗死 ,药物治疗组 (n =19)有 3例死亡 ,1例急性心肌梗死 (P <0 0 5 )。PCI组有 1例于术后 2个月因心绞痛复发而复查冠状动脉造影 ,结果显示原病变部位发生再狭窄 ,故再次进行冠状动脉搭桥术。单纯药物治疗组有 1例在随访期间行CABG ,两组间的血运重建率没有差异。结论　冠状动脉血运重建对于左主干病变的患者可提高远期生存率 ,减少终点事件的发生。

The analysis of effect of different therapies on left main disease

Objective To observe on the effect of different therapies on left main disease Methods We divided 1?055 registered patients who suffered from coronary artery disease (CAD) diagnosed by coronary angiograpy into three groups: pure drug therapy, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) group The follow up was carried out from March to May 2001, and the major adverse cardiac events including death, myocardial infarction (MI) and revascularization were observed, in which there were 42 cases of left main disease Results The 42 patients with left main coronary disease were intervened by three therapies including PCI 16 67%, CABG 38 10%,pure medical therapy 45 23% respectively No death or MI was seen in PCI and CABG groups Three patients died and one got acute myocardial infarction (AMI) in pure drug therapy group ( P <0 05) Conclusion Revascularization can reduce the rates of death and myocardial infarction in the long term