孙宇姣,田文,张海山,贾大林,张月兰,齐国先

• 1:中国医科大学第一附属医院心内科

摘要(Abstract)：

目的比较药物洗脱支架(PCI)与冠状动脉搭桥术(CABG)对老年三支冠脉病变的治疗效果及费用。方法选取2007年4月—2008年11月进行冠脉血运重建的176例三支病变的老年患者(年龄60～79岁),其中PCI组106例,CABG组70例。通过术后6个月和12个月随访比较两组终点事件和治疗费用。结果 PCI组平均住院及术后住院日较CABG组明显缩短(10.77±4.92)d比(46.20±16.19)d,(7.68±4.11)d比(19.51±10.04)d;PCI组完全血运重建率与CABG组相比差异有统计学意义(26.4%比100%,P<0.001)。两次随访两组死亡、心梗及脑卒中发生率无明显差异;PCI组的再血管化治疗高于CABG组(P<0.05);心绞痛及胸闷气短差异无统计学意义(P<0.05);CABG组伤口疼痛发生率显著高于PCI组(P<0.05)。总MACCE事件CABG组虽显著低于PCI组(10.0%比21.7%,P=0.04),但将PCI组中计划内分次进行的血运重建从总MACCE中除去后,两组间差异无统计学意义(P=0.09)。联合终点事件两组间亦差异无统计学意义(P=0.08)。总住院费用及药物费用CABG组显著高于PCI组(P<0.001)。手术费用两者相似(P=0.83)。术后治疗费用PCI组显著高于CABG组(P<0.001)。1年总费用CABG组显著高于PCI组(P<0.001)。两组中完全血运重建者1年费用总和CABG组仍显著高于PCI组(P<0.001)。术后PCI组抗血小板及他汀用药显著优于CABG组。结论对老年三支冠脉病变患者进行药物洗脱支架与冠脉搭桥术的疗效和费用进行综合分析后,提示药物洗脱支架治疗优于冠脉搭桥。

关键词(KeyWords)： 冠状动脉疾病;冠状动脉分流术;药物洗脱支架;治疗结果;费用,医疗

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 孙宇姣,田文,张海山,贾大林,张月兰,齐国先

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