冠心病多支血管病不同治疗方法的疗效分析

The analysis of effect about different therapies on multivessel disease of coronary artery disease

目的 :观察不同治疗方法对冠心病多支血管病患者的临床疗效。方法 :对我院 1993年至1998年期间的 10 5 5例分别进行药物治疗、经皮冠状动脉腔内介入术 (PCI)或冠状动脉旁路手术 (CABG)治疗的冠心病患者进行随访研究。结果 :1.从远期疗效看 ,多支血管病变的终点事件发生率PCI组为9 10 % ,CABG组为 5 6 6 % ,药物治疗为 15 34% (P =0 0 3) ,3组间存在显著性差异 ;且多支血管病变的心绞痛复发率PCI组为 4 0 91% ,CABG为 2 9 2 5 % ,药物治疗为 4 8 5 7% ,(P =0 0 0 6 ) ,3组间存在显著性差异。其中CABG的心绞痛复发率显著低于PCI组 (P =0 0 4 1)。 2 .从近期疗效看 ,多支血管病的近期死亡与总终点事件的发生率CABG组最高 ,显著高于PCI和药物治疗组 (P <0 0 5 )。结论 :多支血管病的血运重建治疗与药物治疗比较 ,其远期的终点事件发生率低于药物治疗组 ,心绞痛复发率CABG组显著低于PCI与药物治疗组 ,近期终点事件发生率CABG组显著高于PCI组和药物治疗组。

Objective:observation on the effect about different therapy on multivessel disease of coronary artery disease; Method:1 055 registered patients(from 1993to 1998) suffered from coronary artery disease(CAD) were followed up.Result:1.In the group of multivessel disease, the longterm rate of Major Adverse Cardiac Events (MACEs) was percutaneous coronary intervention(PCI) 9 10%,coronary artery by pass graft(CABG) 5 66%,pure drug therapy 15 34%,respectively, P =0 03. And the rate of angina recurrence were PTCA 40 91%,CABG 29 25%, pure drug therapy 48 57%, P =0 006.Conclusion:In the multiple vessels disease group, the rate of MACEs was lower in the group of PCI and CABG than in the group of medicine therapy; the rate of angina recurrence was the lowest in the group of CABG. [