林运,陈韵岱,宋现涛,苑飞,顾承雄,黄方炯,吕树铮

• 1:首都医科大学附属北京安贞医院心内科
• 2:北京解放军总医院心内科
• 3:首都医科大学附属北京安贞医院心内科

摘要(Abstract)：

目的评价真实临床环境下不同血运重建方法对冠心病左主干病变患者的近期及远期疗效。方法将我院1995年至2005年10年期间接受血运重建治疗的左主干病变冠心病患者分为金属裸支架(BMS)治疗组、西罗莫司洗脱支架(SES)治疗组以及冠状动脉旁路移植术(CABG)组,记录患者围手术期、术后6个月、术后1年不良心脑血管事件(MACCEs)发生率;接受支架治疗的患者术后6～9个月均要求复查冠状动脉造影;所有患者每月心内科门诊就诊,记录患者心绞痛复发等情况。结果(1)自1995年至2005年期间我院共收治左主干病变冠心病患者415例,其中1995年10月至1999年8月共有97例接受了BMS治疗,1999年9月至2005年5月共有122例接受了SES治疗,1995年至2005年共有196例接受CABG治疗;(2)CABG组糖尿病患者比例高于BMS组及SES组,而在PCI组(包括MS组和SES组)合并肾功能不全、脑血管疾患及肺功能障碍患者比例高于CABG组;(3)BMS组、SES组及CABG组手术、住院期间及术后30d内的MACCEs事件发生率分别为3.09%、4.01%及10.71%,P<0.01;BMS组及SES组住院时间显著短于CABG组(分别为5d、5d及8.5d);(4)SES组造影再狭窄率显著低于BMS组(9.9%比23.6%,P<0.01);(5)平均随访1年SES组与CABG组无MACCEs事件生存率显著高于BMS组(分别为85%、84%、64%,P<0.01)。结论真实临床环境下左主干病变血运重建治疗即刻手术成功率高,PCI组围手术期不良心脑血管事件发生率低于CABG组,SES组与CABG组1年无事件生存率类似,均显著高于BMS组。

关键词(KeyWords)： 冠状动脉疾病;支架;冠状动脉旁路移植术

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 林运,陈韵岱,宋现涛,苑飞,顾承雄,黄方炯,吕树铮

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