陈彭生,李旭东,路雯,崔磊,陈震,韩冰,黄宜杰

• 1:徐州市中心医院心内科
• 2:宝鸡市人民医院心内科
• 3:徐州市心血管病研究所

摘要(Abstract)：

目的 探讨心肌桥（MB）对冠状动脉左前降支慢性完全闭塞（CTO）病变介入治疗及临床预后的影响。方法 本研究回顾性分析了2023年1月至2024年6月徐州市中心医院心内科行左前降支CTO病变介入治疗的患者，根据是否存在显著心肌桥分为有心肌桥组和无心肌桥组，术后随访1年，主要终点为主要不良心血管事件（MACE）的复合事件，包括心源性死亡、心肌梗死、靶血管血运重建、心源性再住院、心力衰竭、复发性严重心绞痛；次要终点包括全因死亡，手术成功率和并发症以及MACE的各个指标的发生率。结果 共纳入262例符合纳排标准的患者，其中有心肌桥组154例，无心肌桥组82例，左前降支成功开通患者224例；无法评估是否存在心肌桥患者26例。有心肌桥组相比较无心肌桥组，手术成功率更低（84.4%比95.1%,P=0.006），术后并发症发生率更高（17.5%比2.4%,P=0.001）,1年MACE累积发生率更高（30.9%比7.3%,P<0.001,HR 5.670,95%CI 2.306～13.939），其中，有心肌桥组的复发性严重心绞痛（12.5%比1.2%,P=0.002）、心源性再住院（21.7%比3.7%,P<0.001）和靶血管血运重建（13.8%比3.7%,P=0.013）发生率更高。多因素Logistic回归分析提示存在显著心肌桥（OR 6.614,95%CI 2.576～16.986,P<0.001）是左前降支CTO病变患者术后1年MACE的独立危险因素。结论 对于左前降支CTO病变患者，心肌桥的存在会增加介入治疗的风险，以及1年更高的心血管事件。显著心肌桥是左前降支CTO病变患者介入治疗和1年发生MACE的独立危险因素。

关键词(KeyWords)： 冠状动脉心肌桥;冠状动脉慢性完全闭塞;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目（82370329）;; 徐州市科技计划项目（KC17125）

作者(Author): 陈彭生,李旭东,路雯,崔磊,陈震,韩冰,黄宜杰

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