经皮冠状动脉介入治疗冠心病左心功能不全的疗效

Cinical study of percutaneous coronary intervention on the treatment of left heart insufficiency derived from ischemic cardiomyopathy

目的探讨经皮冠状动脉介入治疗(PCI)冠心病左心功能不全的疗效。方法选择2007年3月—2011年1月在我院心血管内科住院确诊的冠心病并发左心功能不全患者155例,按照是否行经皮冠状动脉介入治疗分成两组,经皮冠状动脉介入联合药物治疗组(A组)81例,单纯药物治疗组(B组)74例,比较两组治疗后1年胸痛和(或)胸闷控制率、左心功能不全症状缓解率以及心源性死亡发生率之间的差异。结果胸痛和(或)胸闷控制率:A组82.7%(67/81),B组55.4%(41/74),差异有统计学意义(P<0.05);左心功能不全症状缓解率:A组67.9%(55/81),B组39.2%(29/74),差异有统计学意义(P<0.05);心源性死亡发生率:A组3.7%(3/81),B组8.1%(6/74),差异无统计学意义(P>0.05)。结论经皮冠状动脉介入联合药物治疗冠心病左心功能不全与单纯药物治疗相比,能改善胸痛和(或)胸闷及左心功能不全,但未能降低1年期心源性死亡率。

Objective To investigate the effects of percutaneous coronary intervention （PCI） on the treatment and prognosis of left heart insufficiency derived from ischemic cardiomyopathy. Methods 155 patients with left heart insufficiency derived from ischemic cardiomyopathy from March 2007 to January 2011 in our hospital were divided into two groups： group A （81 cases）, received PCI as well as conservative medication; group B （74 cases）, treated with conservative medication only. The remission rate of chest pain and/or Chest tightness, left ventricular dysfunction and the incidence of cardiac death were com- pared between two groups. Results The remission rate of chest pain and/or Chest tightness in group A （82. 7%, 67/81 ） were significantly higher than that in group B （55. 4%, 41/74） （P 〈 0. 05 ） . The remission rate of left ventricular dysfunction in group A （67.9%, 55/81 ） were significantly higher than that in group B （39. 2%, 29/74） （P 〈0. 05） . The incidence of cardiac death in group A （3.7%, 3/81） was lower than that in group B （8.1%, 6/74）, but there was no significant differ- ence between two groups （P 〉 0.05 ） . Conclusion The application of PCI can relieve the symptom of coronary artery dis- ease and left ventricular dysfunction in patients with left heart insufficiency derived from ischemic cardiomyopathy, but can not re- duce the incidence of cardiac death in 1 year.