介入治疗单支血管慢性完全闭塞病变的预后评估

Prognostic assessment of percutaneous coronary intervention for single vessel chronic total occlusion

目的 探讨经皮冠状动脉介入(PCI)治疗单支血管慢性完全闭塞(CTO)病变对患者左心室功能及预后的影响.方法 选取2016年8月至2017年8月就诊于郑州大学第一附属医院心内科的单支主要血管CTO患者219例,其中113例经CTO-PCI成功开通病变血管,纳入PCI组;106例予以优化药物治疗(OMT),纳入OMT组.观察两组患者术前及术后6、12个月心脏多普勒彩色超声与N末端脑钠肽前体(NT-proBNP)改变情况及主要心血管不良事件(MACE)发生情况.结果 PCI组心脏多普勒彩色超声与NT-proBNP均较术前改善且改善程度优于OMT组(P<0.05).PCI组MACE发生率低于OMT组,差异有统计学意义(P<0.05).结论 PCI治疗单支血管CTO能够改善患者心功能,减少1年内心绞痛再发情况,且PCI对CTO患者心功能改善程度优于OMT.

Objective To investigate the effects of percutaneous coronary intervention(PCI)on&nbsp;left ventricular function and prognosis in patients with single vessel chronic total occlusion(CTO).Methods A total of 219 patients admitted to the Department of Cardiology of the First Affilated Hospital of Zhengzhou University from August 2016 to August 2017 were selected.All patients were diagnosed with single vessel CTO.Among them,113 patients were successfully treated by PCI and included in the PCI group.And 106 patients were treated by optimal medical therapy(OMT)and included in the OMT group.The ultrasound cardiogram index,N-terminal pro-B-type natriuretic peptide(NT-proBNP)level,and the major adverse cardivovascular events(MACE)at baseline and 6 months and 12 months after treatment were observed and analyzed between the two groups.Results Compared with baseline,the ultrasound cardiogram index and NT-proBNP were improved,and the improvement of ultrasound cardiogram index and NT-proBNP in PCI group was greater than that in OMT group(P<0.05).The MACE rate in PCI group was lower than that in OMT group,and the differences were statistically significant(P<0.05).Conclusions PCI in the treatment of single vessel CTO can improve cardiac function and reduce the recurrent angina pectoris of patients in 1 year.PCI therapy is more effective than OMT in patients with single vessel CTO.