王韶屏,刘严慈,吴铮,郑泽,彭红玉,赵东晖,李芳,程姝娟,柳景华

• 1:首都医科大学附属北京安贞医院冠心病中心

摘要(Abstract)：

目的 对比经皮冠状动脉介入治疗（PCI）和冠状动脉旁路移植术（CABG）治疗冠状动脉粥样硬化性心脏病（CAD）合并左心室收缩功能不全患者的血运重建效果。方法 研究纳入2005年1月1日至2014年12月31日首都医科大学附属北京安贞医院905例CAD合并左心室射血分数（LVEF）降低（≤35%）的患者。对比PCI和CABG治疗后患者的短期和长期全因死亡率、因心力衰竭再入院发生率和再次血运重建率。采用倾向性评分匹配两组患者基线资料。结果 与CABG组相比，PCI组患者术后30 d死亡率更低（HR 0.29,95%CI 0.09～0.88,P=0.029）。平均随访4.5年结果发现，PCI与CABG的全因死亡率（HR 1.00,95%CI 0.67～1.50,P=0.990）以及因心力衰竭再入院发生率（HR 0.81,95%CI 0.40～1.64,P=0.561）差异均无统计学意义。PCI组患者再次血运重建发生率更高（HR 14.46,95%CI 3.43～60.98,P<0.001），差异有统计学意义。与CABG比，PCI能更显著地改善患者心功能（交互作用P=0.031）。结论 在CAD合并LVEF降低患者中，与CABG相比，PCI有着更低的短期死亡率，同时心功能改善更显著，但再次血运重建发生率更高。PCI与CABG的长期生存率以及因心力衰竭再入院风险相似。

关键词(KeyWords)： 冠状动脉旁路移植术;左心室射血分数;心力衰竭;血运重建;支架

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王韶屏,刘严慈,吴铮,郑泽,彭红玉,赵东晖,李芳,程姝娟,柳景华

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