冠状动脉搭桥术与经皮冠状动脉介入术治疗左主干冠状动脉病变的效果比较

Comparison on effects of coronary artery bypass grafting and percutaneous coronary intervention on left main coronary artery lesions

目的比较冠状动脉搭桥术(CABG)与经皮冠状动脉介入术(PCI)治疗左主干冠状动脉(LMCA)病变的效果。方法将焦作市人民医院2021年2月至2023年2月收治的86例左主干冠状动脉病变患者按治疗方式分为对照组与观察组,每组43例。对照组行CABG治疗,观察组行PCI治疗。比较两组住院时间、心功能指标[左心室射血分数(LVEF)、脑钠肽(BNP)、N末端B型钠尿肽原(NT-proBNP)]、心功能分级改善情况、术后6个月心血管不良事件(MACCE,包括心绞痛、心肌梗死、再次血运重建、心源性死亡等)发生情况。结果观察组住院时间短于对照组,差异有统计学意义(P<0.05)。治疗后,观察组LVEF、BNP、NT-proBNP、心功能NYHA分级与对照组比较,差异均未见统计学意义(P>0.05),但与本组治疗前比较均有明显改善(P<0.05)。观察组术后再次血运重建发生率、MACCE总发生率均高于对照组,但差异未见统计学意义(P>0.05),观察组心绞痛发生率高于对照组,差异有统计学意义(P<0.05)。结论CABG与PCI治疗LMCA病变的近期治疗效果相近,但CABG远期预后效果优于PCI,而PCI术后恢复时间更短。

Objective To compare the effects of coronary artery bypass grafting(CABG)and percutaneous coronary intervention(PCI)on left main coronary artery(LMCA)lesions.Methods 86 patients with left main coronary artery disease admitted to Jiaozuo People's Hospital from February 2021 to February 2023 were divided into a control group and an observation group according to the treatment method,with 43 cases in each group.The control group received CABG treatment,while the observation group received PCI treatment.Compare the length of hospital stay,cardiac function indicators,including left ventricular ejection fraction(LVEF),brain natriuretic peptide(BNP),and N-terminal B-type natriuretic peptide(NT proBNP),improvement in cardiac function grading,and incidence of cardiovascular adverse events(MACCE)at 6 months post surgery,including angina,myocardial infarction,revascularization,and cardiac death between two groups.Results The hospitalization time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the LVEF,BNP,NT proBNP,and NYHA grading of heart function in the observation group were compared with the control group,and the differences were not statistically significant(P>0.05),but there was a significant improvement compared with before treatment in this group(P<0.05).The incidence of postoperative revascularization and total incidence of MACCE in the observation group were higher than those in the control group,but the difference was not statistically significant(P>0.05).The incidence of angina in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusions CABG and PCI have similar short-term treatment effects for LMCA lesions,but CABG has a better long-term prognosis than PCI,and the recovery time after PCI is shorter.