冠状动脉旁路移植术治疗急性冠状动脉综合征的临床疗效

The clinical curative effect of coronary artery bypass graft in the treatment of acute coronary syndrome

目的探讨冠状动脉旁路移植术（CABG）治疗急性冠状动脉综合征（ACS）的疗效。方法对64例ACS患者的临床资料进行回顾性分析，按手术方法不同分组，其中行CABG治疗41例（CABG组），行经皮冠状动脉介入治疗（PCI）23例（PCI组），比较两组患者主要心脏事件及次要心脏事件的发生情况。结果CABG组院内心脑血管事件发生率为7．32％（3，41），PCI组为8．70％（2／23），两组比较差异无统计学意义（P〉0．05）。无失访患者，随访12—48个月，CABG组中位随访时间为35．26个月，PCI组为33．19个月。随访期间CABG组心脑血管事件发生率为19．51％（8，41），PCI组为30．43％（7/23），两组比较差异无统计学意义（P〉0．05）；两组患者病死率、心肌梗死率、脑血管事件发生率、心绞痛发生率、总心脑血管事件发生率比较差异均无统计学意义（P〉0．05）。结论ACS的外科治疗是可行的，CABG治疗ACS与PCI疗效相当，术式要依据患者病情个性化选择，选择合适的血运重建方式才能得到最佳疗效。

Objective To explore the curative effect of coronary artery bypass graft （CABG） in the treatment of acute coronary syndrome （ACS）. Methods Clinical data of 64 patients with ACS were retrospectively analyzed, 41 patients received CABG （CABG group） and 23 patients received peroutaneous coronary intervention （PCI, PCI group）. Mainly cardiac events and secondary cardiac events were compared. Results The incidence rate of cadiovascular and cerebrovascular events during hospitalization in CABG group was 7.32%（3/41 ）, in PCI group was 8.70%（2/23 ）, there was no significant difference （P 〉 0.05）. All patients accomplished follow-up and follow-up time was 12 - 48 months. The meta follow-up time in CABG group was 35.26 months, in PCI group was 33.19 months. The incidence rate of cadiovascular and cerebrovaseular events during follow-up in CABG group was 19.51% （8/41）,in PCI group was 30.43% （7/23）, there was no significant difference （P 〉 0.05 ）. The incidence rate of death, myocardial infarction, cerebrovaseular events, angina pectoris and total cadiovascular and cerebrovascular events between two groups had no significant difference （P 〉 0.05 ）. Conclusions The surgery treatment in ACS is feasible, the curative effect of CABG and PCI is therapeutic equivalence. The choice of operation should be based on patients＇ condition and individual choice. Appropriate revascularization can get the best treatment ettieiency.