摘要
目的比较完全性血运重建及部分性血运重建对存在包括前降支在内双支病变的缺血性心肌病(ICM)患者的疗效。方法 112例经选择性冠状动脉造影(SCAG)证实存在包括前降支在内双支病变的ICM患者行冠状动脉介入(PCI)治疗,按是否在前降支行支架植入血运重建基础上对另一支病变冠脉(回旋支或右冠状动脉)行血运重建分为完全性血运重建组(完全重建组)及部分性血运重建组(部分重建组)各56例。术后随访1年,比较两组PCI术中并发症发生率、术前和术后1年的血浆B型利钠肽(BNP)浓度、左心室舒张末期内径(LVDd)、左心室射血分数(LVEF)及心血管不良事件发生率。结果部分重建组PCI术中并发症发生率低于完全重建组,差异有统计学意义(P<0.05);两组术后1年的血浆BNP浓度较术前降低,LVDd较术前减小,而LVEF较术前增加,差异均有统计学意义(P<0.05);但两组之间术前和术后1年的血浆BNP浓度、LVDd及LVEF比较,差异均无统计学意义(P>0.05);两组心血管不良事件发生率比较,差异均无统计学意义(P>0.05)。结论对于存在包括前降支在内双支病变的ICM患者,前降支选择性部分血运重建及完全性血运重建均能有效改善患者的心功能,且前者PCI术中并发症发生率更低。
Objective To compare the efficacies between complete revascularization and partial revascularization for ischemie cardiomyopathy (ICM) patients with double coronary lesions. Methods A total of 112 ICM patients with double coronary lesions, including selective coronary angiography (SCAG) proven affected anterior descending coronary artery, were treated by percutaneous coronary intervention (PCI). All patients were divided into two groups according to different revascularization strategies : complete revascularization group ( n = 56 ) , in which participants received stent implantation on both coronary lesions ; and partial revascularization group ( n = 56), in which participants received stent im- plantation on anterior descending coronary artery only. Followed up for 1 year. The incidence of complication during operation, the level of plasma B -type natriuretic peptide (BNP), the left ventricular end diastolic dimension (LVDd), the left ventricular ejective fraction (LVEF) before and 1 year after interventions were compared. The incidence of 1 - year adverse cardiac events after interventions was also compared. Results The incidence of complication during operation in partial revascularization group was significantly lower than that in complete revascularization group ( P 〈 0. 05 ). The plas- ma BNP level and LVDd 1 year after interventions were significantly lower than that before interventions in both groups ( P 〈 0. 05). The LVEF 1 year after interventions was significantly higher than that before interventions in both groups (P 〈 0. 05 ). There was no significant difference between complete revascularization group and partial revascularization group in BNP, LVDd or LVEF before or 1 year after interventions (P 〉 0. 05 ). There was no significant difference between com- plete revascularization group and partial revascularization group in the incidence of 1 - year adverse cardiac events (P 〉 0. 05 ). Conclusion Both partial revascularization and complete revascularization effectively improve the cardiac function of ICM patients with double coronary lesions including anterior descending coronary artery, and there is lower incidence of complication during operation in partial revascularization.
出处
《广东医学》
CAS
北大核心
2017年第9期1367-1370,共4页
Guangdong Medical Journal
基金
汕头市医疗科技计划项目(编号:汕府科[2014]62号-14)
关键词
血运重建
冠状动脉介入
双支病变
前降支
缺血性心肌病
心功能
coronary revascularization
percutaneous coronary intervention
double coronary lesions
anterior descending coronary artery
ischemic cardiomyopathy
cardiac function