姜东炬,付荣,胡高频,贾玉琳,王冬冬,张燕波,薛博文,陶爱萍

• 1:沈阳军区大连心血管内科疾病诊疗中心
• 2:沈阳军区第210医院心内科

摘要(Abstract)：

目的评价对冠心病引起的严重心力衰竭冠状动脉三支血管病变仅单支开放的患者行经皮冠状动脉介入治疗(PCI)的安全性和有效性。方法 2004年9月至2013年12月因冠心病引起的严重心力衰竭入院并接受PCI的患者中,27例患者冠状动脉造影显示三支血管严重病变,其中两支血管呈慢性完全闭塞病变(CTO),单支开放的冠状动脉存在严重狭窄、但无明显钙化弯曲。对27例冠状动脉严重狭窄仅单支开放的患者行PCI,观察PCI造影和临床成功率,院内临床症状、术前及术后1周血浆脑钠肽(BNP)、左心室射血分数(LVEF)变化及30 d主要不良心脏事件(MACE,包括死亡、心肌梗死、靶血管再次血运重建)发生率。结果 PCI即刻造影及临床成功率均为27例(100%)。术后胸闷气短症状改善为27例(100%),NYHA心功能分级由Ⅳ级提高到Ⅲ级有22例(81.5%)。术前与术后1周血浆BNP[(2699.6±1104.7)pg/ml比(737.0±261.7)pg/ml,P<0.05]、LVEF[(26.89±5.70)%比(36±3.41)%,P<0.05]比较,差异有统计学意义。术后发生对比剂肾病1例(3.7%),经床旁血液透析48 h后肾功能恢复。院内及30 d随访,未发生MACE。结论冠心病引起的严重心力衰竭冠状动脉三支血管病变患者,在两支血管CTO未开通情况下,对严重狭窄但无明显钙化弯曲的单支开放冠状动脉病变行PCI成功率高,短期观察安全有效。

关键词(KeyWords)： 冠心病;心力衰竭;单支开放冠状动脉病变;经皮冠状动脉介入治疗

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 姜东炬,付荣,胡高频,贾玉琳,王冬冬,张燕波,薛博文,陶爱萍

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