不同类型右冠状动脉慢性完全闭塞患者介入治疗后心功能的改善情况

Post-intervention therapy cardiac function improvement in patients with different types of chronic total occlusion in right coronary artery

目的观察不同类型右冠状动脉慢性完全闭塞(CTO)患者介入治疗后心功能的改善情况。方法回顾性分析行介入治疗的168例右冠CTO患者的临床资料,根据左室射血分数将患者分为A组(心功能保留组,52例)和B组(心功能下降组,116例)。比较手术前后两组患者心功能改善情况。结果A组有36例成功开通右冠脉(A1组),未成功开通右冠脉16例(A2组);B组88例成功开通右冠脉(B1组),未成功开通右冠脉28例(B2组)。术后1年,A1和A2组患者左室射血分数、左室舒张末期内经(LVEDD)、纽约心脏协会(NYHA)分级及LDL-C水平差异均无统计学意义,组内手术前后上述指标比较差异均无统计学意义(均P>0.05);B1组患者左室射血分数高于术前及B2组,LVEDD、NYHA分级低于术前及B2组(均P<0.05),B2组左室射血分数较术前降低,LVEDD较术前升高(均P<0.05)。结论心功能下降的右冠CTO患者行介入治疗成功开通右冠脉后,其心功能得到改善,但该疗法对心功能保留的患者效果不明显。

Objective To observe the post-intervention therapy cardiac function improvement in patients with different types of chronic total occlusion(CTO)in the right coronary artery.Methods The clinical data of 168 patients with CTO in the right coronary artery were analyzed retrospectively,all patients received intervention therapy,and were divided into group A(with cardiac function preservation,52 cases)and group B(with cardiac function decline,116 cases)according to their left ventricular ejection fraction.Cardiac function improvement was compared between the two groups before and after treatment.Results In group A,36 cases obtained right coronary repatency(group A1)and 16 cases failed in right coronary repatency(group A2);in group B,88 cases obtained right coronary repatency(group B1)and 28 cases failed in right coronary repatency(group B2).One years after surgery,there was no statistically significant difference in left ventricular ejection fraction,left ventricular end-diastolic dimension(LVEDD),classification of New York Heart Association(NYHA),or LDL-C level between group A1 and group A2(P>0.05),the indices mentioned above before and after treatment showed no statistically significant differences in each group(all P>0.05);group B1 had higher left ventricular ejection fraction,lower LVEDD and NYHA class than the preoperative and group B2(all P<0.05),group B2 had decreased left ventricular ejection fraction and increased LVEDD in contrast with the preoperative(all P<0.05).Conclusion Patients with CTO in the right coronary artery,who experience cardiac function decline,might achieve successful right coronary repatency and cardiac function improvement after intervention therapy,but this therapy has no obvious effects on patients with cardiac function preservation.