冠状动脉旁路移植术患者的临床分析

Clinical Analysis of Patients Undergoing Coronary Artery Bypass Grafting

目的 分析冠心病患者行冠状动脉旁路移植术 (CABG)的临床资料 ,了解目前 CABG患者的流行病学、相关临床特征和变化趋势。 方法 分析 2 0 0 0～ 2 0 0 1年间行 CABG6 5 1例患者的年龄分布、相关疾病、心肌梗死、冠状动脉造影、心电图与超声心动图表现以及血管旁路移植情况等 ,并与 1974～ 1995年我院 CABG患者资料比较。结果 冠状动脉造影显示 93.2 % (6 0 7/ 6 5 1)的患者有左前降支病变 ,3支、2支和单支病变者各占 6 4 .1% (417/ 6 5 1)、2 4 .1% (15 7/ 6 5 1)和 11.8% (77/ 6 5 1)。有高血压、糖尿病和高血脂症史的患者 ,在心肌梗死、移植血管支数等方面与无此类病史者差别具有显著性意义 (P<0 .0 0 5 ,P<0 .0 0 1和 P<0 .0 0 1)。行 CABG的患者仍以 6 1～ 70岁者为多 ,占4 5 % (2 93/ 6 5 1)。移植血管支数以 4支及以上较多 ,为 5 5 .6 % (36 2 / 6 5 1) ,93.7% (6 10 / 6 5 1)的患者采用左乳内动脉作为血管移植材料。 结论 近年来 CABG患者的病情较以前复杂 ,但手术疗效有明显提高。

ObjectiveTo analyse patient history and clinical data of those patients underwent coronary artery bypass grafting(CABG), epidemiology and related clinical changes of coronary artery atherosclerotic heart disease were explored. MethodsSix hundred and fifty-one consecutive coronary artery atherosclerotic heart disease patients in Fuwai Hospital from 2000 to 2001 underwent CABG therapy, with mean age of 60.1 years. Patient age, clinical history of myocardial infarction and related diseases, angiogram, electrocardiogram, echocardiography and number of grafting were compared with prior data during 1974-1995 in our hospital.ResultsAngiogram showed almost all patients had left anterior descending branch disease(607/651,93.2%). The incidences of triple, double and single vessel disease were 64.1%(417/651), 24.1%(157/651) and 11.8%(77/651), respectively. Patients with hypertension, diabetes and hyperlipemia had higher incidence of myocardial infarction and multiple grafts(P<0.005, P<0.001, P<0.001 correspondingly). The largest population of CABG was still among 61-70 years of age (293/651,45%). Most patients had 4 or more vessels grafted during CABG in this study (362/651, 55.6%), and most patients had left internal mammary artery served as grafted materials(610/651,93.7%).ConclusionAlthough risk factors of CABG procedure increased in recent years, the clinical result is still very affirmative.