经皮冠状动脉介入术治疗冠状动脉左主干病变疗效观察

Effect of percutaneous coronary artery interventional therapy on unprotected left main coronary artery disease

目的观察经皮冠状动脉介入术（PCI）治疗无保护冠状动脉左主干（ULMCA）病变的疗效。方法对40例ULMCA病变患者采用PCI治疗，随访6～20个月，观察心血管不良事件（MACE）的发生情况。结果所有患者经PCI治疗即时成功率100．0％，术中无严重并发症。住院期间未发生严重心血管不良事件。术后随访6～20（7±2）个月，术后4周发生急性心肌梗死1例，CAG证实回旋支开口亚急性支架内血栓形成，再次PCI治愈；术后动员28例患者在6—12个月进行CAG复查，其中回旋支开V1支架内再狭窄3例，左主干远端-前降支开口再狭窄1例，2例再狭窄患者有心绞痛症状，3例再次行PCI，无需要CABG患者。随访期间无死亡病例。心血管不良事件总的发生率12．5％（5／40），再狭窄率10．0％（4／40）。结论对经过选择的ULMCA病变进行PCI是安全可行的，有良好的近远期预后。

Objective To observe the effect of percutaneous coronary intervention（PCI） treatment on unprotected left main coronary artery（ULMCA） lesion. Methods 40 patients with ULMCA lesions treated with PCI were followed up for 6 to 20 months, adverse cardiovascular events （MACE） occurrence were observed. Results All patients treated by immediate PCI success rate was 100.0%. There were no serious complications. There were no serious adverse cardiovascular events during hospitalization. Patients were followed up 6 -20 （7±2 ）months ,4 weeks after op- eration, acute myocardial infarction in 1 case, CAG confirmed circumflex artery open subacute stent thrombosis, re-PCI cure;postoperative mobilization of 28 patients took CAG in 6 - 12 months, including the opening circumflex artery stent restenosis in 3 cases, one distal left anterior descending branch of the trunk opening and then stenosis,2 cases of restenosis in patients with angina symptoms,3 patients re-line PCI, no need to CABG patients. No deaths during followup. The overall incidence of cardiovascular adverse events rate was 12. 5% （5/40）, restenosis rate was 10. 0% （4/40）. Condusion The choice of ULMCA lesions after PCI was safe and feasible,with good short and long term prognosis.