冠脉临界病变的评价

Evaluation of coronary borderline lesion

目的评价冠脉临界病变患者药物治疗或介入治疗的疗效。方法对2003年7月至2004年12月在上海市胸科医院心内科行冠脉造影(CAG)显示病变血管狭窄程度<50%的84例冠心病患者资料进行分析。所有患者随访6～12个月,记录主要不良心血管事件(MACE:包括心源性死亡、非致死性心梗、心绞痛复发、因支架内再狭窄再次血运重建)。结果4例患者因症状典型、术前负荷试验为阳性、实验室检查异常,CAG发现病变位于LAD,狭窄程度50%左右,考虑不稳定斑块可能,予以介入治疗(PCI)。所有患者住院期间无MACE发生。4例PCI治疗患者术后症状改善,2～3个月后复查运动平板试验均转为阴性。随访期间有2例患者发生MACE事件(2.4%)。结论对于存在多种高危因素的冠脉临界病变的患者,PCI治疗可能优于药物治疗,随访的结果显示PCI治疗将有助于改善患者的生活质量,并减少MACE事件的发生。

Objective To evaluate the effect of PCI and drug treatment in borderline lesion. Methods 84 CHD patients whose lesion stenosis was about 50% were retrospectively analysed during Jul. 2003 to Dec. 2004. Patients were follow-up in 6 to 12 months and recorded MACE （death, AMI, angina relapse, restenosis instent）. Results 4 patients with borderline lesion in LAD got PCI because of typical symptom and positive exercise test. 2 month after implanting stent, they were free from the symptom and the exercise test result were negative. There was no MACE in hospital. During the follow-up, 2 patients （2.4%） had MACE. Conclusion Those borderline lesion patients who had multiple coronary risk factors may get benefit from PCI, which could improve patients＂ living quality and reduce MACE.