张剑,荆全民,王效增,马颖艳,王耿,刘海伟,王斌,徐凯,韩雅玲

• 1:沈阳军区总医院心内科全军心血管病研究所

摘要(Abstract)：

目的总结并探讨无心肌梗死(MI)病史的冠状动脉慢性完全闭塞病变(CTO)冠心病患者的临床、影像学和经皮冠状动脉介入治疗(PCI)的特点。方法纳入1995年7月至2014年12月在沈阳军区总医院心内科行PCI的连续性绝对性CTO冠心病患者共2651例,其中无MI病史患者1466例(55.3%,无MI组),有MI病史患者1185例(44.7%,MI组)。结果无MI组患者年龄、女性比例、不稳定型心绞痛比例、高血压病比例、血清三酰甘油水平及左心室射血分数(LVEF)均显著高于MI组,差异均有统计学意义(均P<0.05);而无MI组患者心力衰竭比例和血肌酸酐水平均显著低于MI组,差异均有统计学意义(均P<0.001)。无MI组患者多支病变比例(81.4%比76.5%,P=0.002)高于MI组;在CTO靶血管分布方面,无MI组患者左前降支比例(36.2%比40.7%,P=0.007)显著低于MI组,而左回旋支比例(17.0%比12.7%,P<0.001)、侧支循环良好比例(32.7%比27.0%,P<0.001)显著高于MI组,差异均有统计学意义。两组患者CTO靶血管PCI成功率、完全血运重建比例、平均支架置入数、平均支架直径和平均支架总长度比较,差异均无统计学意义(均P>0.05)。结论无MI病史的CTO冠心病患者因为年龄、性别、不稳定型心绞痛反复缺血预适应、高血压病等因素,可能促进了侧支循环的建立,使心功能得到保护。

关键词(KeyWords)： 心肌梗死;慢性完全闭塞病变;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 张剑,荆全民,王效增,马颖艳,王耿,刘海伟,王斌,徐凯,韩雅玲

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