冠状动脉介入治疗对缺血性心肌病患者心功能和预后的影响

Effects of percutaneous coronary intervention on heart function and prognosis in patients with ischemic cardiomyopathy

目的观察经皮冠状动脉介入治疗(PCI)对缺血性心肌病(ICM)患者心功能及预后的影响。方法将98例缺血性心肌病患者随机分为治疗组48例和对照组50例,2组均给予常规药物治疗,治疗组在此基础上施行国产雷帕霉素药物涂层支架置入术。观察2组治疗前及治疗后1年、3年纽约心功能分级及心脏超声变化,统计不良事件(心绞痛、心力衰竭、再次入院人次)发生情况。结果治疗组治疗后1年、3年纽约心功能分级及心脏超声变化均好于对照组,不良事件发生率低于对照组。2组心肌梗死、心源性死亡发生率比较差异无统计学意义。结论 PCI是治疗缺血性心肌病的有效方法,可明显改善患者心功能、心绞痛等临床症状,提高患者生活质量,对改善预后有一定价值。

Objective It is to observe the efficacy of percutaneous coronary intervention （PCI） on heart function and prog- nosis in patients with ischemic cardiomyopathy. Methods Ninety-eight patients with ischemic cardiomyopathy were randomly divided into treatment group with 48 cases and control group with 50 cases. Both the groups were given routine medicine thera- py. Among them, the treatment group was also given rapamycin-coated stent by percutaneous coronary intervention. NYHA classification, echocardiography were observed, and the occurrence of adverse events （angina Pectoris, heart failure, and number of reoccurrences led to re-hospitalization） were recorded pre - , 1 yr and 3 yr post-therapy. Results PCI treatment group was significant different from control group only in terms of NYHA classification, echocardiography, and occurrence of adverse events. However, there was no significant difference due to myocardial Infarction or cardiac death between two groups. Conclusion PCI is an effective therapy and has positive significance in enhancing patient＇ s clinical syndromes such as heart function, angina pectoris. It is also valuable to improve patient＇ s quality of life and prognosis.