血运重建方式对冠心病三支病变患者预后的影响Impact of completeness of coronary revascularization on prognosis of patients with three-vessel disease
邓晓莉,张福春,赵月,朱昀,郭静萱,高炜
摘要(Abstract):
目的观察不同的冠状动脉血运重建方式——完全血运重建(冠状动脉介入治疗或冠状动脉旁路移植术)或部分血运重建(冠状动脉介入治疗)对冠心病三支病变患者死亡率和心功能的影响。方法共181名三支病变并行血运重建的患者,按血运重建方式分为两组:部分血运重建组行经皮腔内冠状动脉成形术和/或冠状动脉支架置入术,完全血运重建组行冠状动脉旁路移植术或支架置入术。手术后临床随访6~70个月(平均28.6±9.2个月),比较两组随访病例临床终点事件和心功能的差异。结果(1)基线资料:对部分血运重建组123例和完全血运重建组58例进行了临床随访,两组在年龄及性别方面差异无统计学意义。(2)临床事件:部分血运重建组死亡9例(7.32%),完全血运重建组死亡5例(8.62%);部分血运重建组再入院17人(13.8%),完全血运重建组再入院7人(10.3%),两组之间差异均无统计学意义(P>0.05)。选择完全血运重建或部分血运重建对患者28个月的死亡率和心功能无显著影响(P>0.05)。治疗前左室射血分数对患者的死亡率有显著影响(P=0.004,95%CI=0.893~0.978)。结论临床选择冠状动脉完全血运重建或部分血运重建对冠状动脉三支病变患者28个月死亡率和心功能的影响差异无统计学意义,而治疗前左室射血分数是影响其远期预后的重要因素。
关键词(KeyWords): 血管成形术,经腔,经皮冠状动脉;冠状动脉分流术;支架;死亡率
基金项目(Foundation):
作者(Author): 邓晓莉,张福春,赵月,朱昀,郭静萱,高炜
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