586例冠状动脉慢性完全闭塞患者经皮冠状动脉介入治疗疗效及相关因素分析

目的:评估经皮冠状动脉介入治疗(PCI)对冠状动脉慢性完全闭塞(CTO)患者的治疗效果,并探讨影响介入治疗效果的相关因素。方法:回顾性分析586例经PCI治疗的CTO患者的临床资料,分析CTO患者行PCI治疗的疗效及相关影响因素。结果:CTO患者PCI的成功率为80%。术中并发症7.7%,分别是冠状动脉穿孔8例,心包压塞5例,支架血栓形成4例,严重心律失常(房扑、房颤、室性心动过速及室颤)22例,手术相关心绞痛6例。影响PCI治疗成功的患者自身因素有年龄(P=0.034)、高血压史(P=0.041)、糖尿病史(P=0.032)、发病至治疗的时间(P=0.008);病变相关因素有冠脉闭塞部位(P0.05)、冠脉分支迂曲程度(P=0.015)、闭塞血管远端缺如(P=0.044)及合并钙化(P=0.007)。结论:CTO患者进行PCI治疗的效果良好。患者的个人病史、病变特点及治疗是否及时是决定介入治疗成功的关键因素。

Clinical effect of percutaneous coronary intervention in treatment of 586 patients with chronic total occlusion of coronary artery and the related influential factors

Objective：To evaluate the effect of percutaneous coronary intervention （PCI） in patients with coronary chronic total occlusion （CTO）,and to explore the influencing factors of interventional therapy.Methods：The clinical data of 586 cases with CTO underwent PCI were analyzed retrospectively.The effects and influencing factors were compared and analyzed.Results：The success rate of PCI was 80%.Intraoperative complications were few （7.7%）,including 8 cases of coronary artery perforation during operation,5 cases of cardiac tamponade,4 cases of stent thrombosis,22 cases of severe arrhythmia （atrial flutter,atrial fibrillation,ventricular tachycardia and ventricular fibrillation）,and 6 cases of operation related angina.The patients＇personal factors which influenced the treatment were age （P =0.034）,history of hypertension （P =0.041）,history of diabetes mellitus （P =0.032）,and the length of time from onset to treatment （P =0.008）.The factors related with the lesions included the location of coronary occlusion （P 〈 0.05）,the tortuousness of coronary artery （P =0.015）,the distal defect （P =0.044） and calcification （P =0.007） of occluded vessels.Conclusion：PCI shows a good effect on patients with CTO.The patients＇personal history,pathological features of the disease and in time for treatment are key factors that influence the success of PCI.