摘要
目的:研究多支血管病变患者冠状动脉(冠脉)内支架术的近期疗效和远期预后。方法:1999年7月～2000年12月连续491例冠心病患者完成选择性冠脉内支架术,其中:单支病变(甲组)250例,多支病变不完全重建(乙组)175例,多支病变完全重建(丙组)66例,比较各组支架术近期及远期结果。结果:甲、乙、丙3组手术并发症发生率(5.6％、6.9％和9.1％)差异无显著性意义(P>0.05)。平均随访时间(12±4.8)个月,随访率为92.3％。3组硝酸酯药物停用率(34.8％、31.9％和38.3％)、心功能改善率(54.3％、44.8％和50.O％)和再入院率(29.1％、38.0％和36.7％)差异均无显著性意义(均P>0.05)。与甲组比较,乙组心绞痛复发率(55.2％:39.1％)和心脏事件发生率(28.8％:17.8％)增高(均P<0.05),与甲组上述指标比较,丙组差异均无显著性意义(均P>0.05)。结论:多支血管病变患者冠脉内支架术安全,远期预后良好,病变血管完全血管重建则远期获益更大。
Objective: To investigate the acute results and long-term prognosis after coronary stenting in patients with multivessel coronary artery disease. Methods: Four hundred and ninety-one consecutive patients who implanted selective coronary stent were divided into three groups. Group Ⅰ included 250 patients with single-vessel coronary stenting, group Ⅱ comprised 175 patients with incomplete multivessel coronary stenting and group Ⅲ contained 66 patients with complete multivessel coronary stenting. Acute results and long-term follow-up outcomes were compared among the three groups. Results: Procedural complication rate(5. 6% vs 6. 9% vs 9. 1%) were not significantly different among the three groups (all P >0. 05). Follow-up rate was 92. 3% (mean duration, 12 ± 4. 8 months). There wae no significant difference in nitrates cessation(34. 8% vs 31. 9% vs 38. 3%), improvement of cardiac function (54.3% vs 44. 8 % vs 50. 0 % ) and re-admission(29.1% vs38.0% vs36.7%) a-mong the three groups (all P > 0. 05). Compared with group Ⅰ, group Ⅱ patients had more recurrent angina (55.2% vs 39. 1%) and higher cardiac event rates (28. 8% vs17.8%) (all P<0. 05), however, these measurements did not significantly differ between group Ⅰ and group Ⅲ (all P >0. 05). Conclusion: Coronary stenting is safe and effective in patients with multivessel coronary artery disease. Furthermore, complete revascularization may bring better clinical improvement in long-term outcome in these patients.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2002年第10期481-483,共3页
Journal of Clinical Cardiology
