冠状动脉多支病变完全与部分血运重建的安全性和疗效比较

Comparison in safety and efficacy between complete revascularization and partial revascularization in patients with CHD multivessel diseases

目的探讨药物洗脱支架(drug-eluting stents,DES)完全性血运重建与部分血运重建治疗冠心病多支病变的安全性和疗效。方法选取2011年1月至2012年11月在河南省胸科医院心内科接受PCI治疗的多支病变(multivessel diseases,MVD)患者205例,年龄35～84岁,男性112例,女性93例。根据血运重建情况分为完全性血运重建组106例;部分血运重建组99例。术后1年内定期于心内科门诊或电话随访患者。记录患者一般临床情况、纽约心脏病协会(NYHA)心功能分级、再次住院、主要不良事件(MACE)发生情况。结果与完全性血运重建组一般情况比较,部分血运重建组年龄、性别比例、合并症发生率、并发症发生率、心功能3级以及再次入院的人数无明显变化(P均>0.05)。完全性血运重建组(5.6%)MACE事件发生率与部分血运重建组(8.8%)比较无统计学差异(P>0.05)。结论功能性部分血运重建治疗冠心病多支病变的疗效不劣于完全性血运重建。

Objective To investigate the safety and efficacy of complete revascularization and partial revascularization of drug-eluting stents （DES） in the treatment of multivessel lesions of coronary heart disease （CHD）. Methods The patients （n=205） treated with PCI because of multivessel diseases （MVD） were chosen from the Chest Hospital of Henan Province from Jan. 2011 to Nov. 2012 （aged from 35 to 84, male 112 and female 93）. According to revascularization state all patients were divided into complete revascularization group （n=106） and partial revascularization group （n=99）. After 1 year, all patients were followed up regularly in clinic or by telephone. The general clinical information, NYHA grades, and incidence of readmission and major adverse cardiovascular events （MACE） were recorded. Results The percentage of age and sex, incidence of complications, NYHA grade 3 and number of readmission had no significant changes in partial revascularization group compared with complete revascularization group （all P＆gt;0.05）. The incidence of MACE had no statistical difference between complete revascularization group （5.6%） and partial revascularization group （8.8%, P〉0.05）. Conclusion The efficacy of partial revascularization is non-inferior to that of complete revascularization.