介入与药物治疗冠心病疗效分析

A comparison of intervention therapy with medical therapy in the treatment of coronary heart disease

目的 比较介入和药物干预对冠心病患者心绞痛症状、急性左心衰竭发生和心功能分级的作用。方法 入选182例冠心病患者 ,介入组 89人 ,药物组 93人 ,门诊随访和信访 (平均随访时间 2 .9年 )患者心绞痛症状、急性左心衰竭发生和心功能分级情况以及两组病人抗心绞痛药物的应用情况。结果 在单支病变而且侧支循环未形成的患者中 ,治疗后介入组心功能分级比药物组好 (P=0 .0 11) ,心绞痛的控制和急性左心衰竭的发生两组间无差别。在多支病变或侧支循环已形成的患者中 ,两种治疗对心绞痛的控制、心功能分级和急性左心衰竭的发生 ,无统计意义差别。β-阻滞剂、抗血小板药和调脂药的使用上介入组比药物组积极。结论 单支病变且侧支循环未形成的稳定型心绞痛患者 ,介入治疗可使心功能分级明显改善。

Objective To compare the effects of interventional therapy with those of medical therapy on the class of angina, incidence of acute heart failure and heart functional grade. Methods 182 patients with coronary heart disease were chosen, 89 cases underwent interventional therapy, 93 cases received medical therapy alone. The mean follow-up interval was 2.9 years. They were followed-up by means of outpatient service and questionnaires, and compared the incidence of acute heart failure, class of angina and heart functional grade. Results In patients with single-vessel disease and incompletely formed collateral circulation,the heart functional grade was better improved in the interventional therapy group than in the medical therapy group(P=0.01), but there were no differences in the control of angina and the incidence of acute heart failure between the two groups. In patients with multi-vessel disease or completely formed collateral circulation, interventional therapy showed no advantages over medical therapy for control of angina, improvement of heart functional grade and reduction of incidence of acute heart failure. The patients underwent interventional therapy took more β-blockers, platelet function inhibitors and lipid-lowering medication than the patients who only received medical therapy. Conclusions This study shows that among the patients with single-vessel disease and collateral circulation incompletely formed, interventional therapy benefits more for heart functional grade compared with medical therapy.