不同血运重建方式治疗冠心病多支病变的预后评价

发布时间：2018-03-27 12:22

本文选题：冠心病　切入点：多支血管病变　出处：《安徽医科大学》2017年硕士论文

【摘要】：目的:对比和评估冠心病多支血管病变(MVD)患者经皮冠脉支架置入术(PCI)与冠状动脉旁路搭桥术(CABG)两种血运重建方式的临床疗效及预后,为MVD患者再血管化策略的选择提供可行性的参考依据。方法:回顾性分析2012年1月至2015年12月在安徽医科大学第一附属医院首次行血运重建治疗的MVD患者437例,其中PCI组225例,CABG组212例。比较两组患者围术期基线资料特征,随访两组患者首要终点事件包括总死亡、心源性死亡、再发心肌梗死、脑血管意外事件及再次血运重建等主要心脑血管不良意外(MACCA)的发生率,次要终点事件即再发心绞痛的发生率。结果:入选患者全部完成随访,随访率为100%,平均随访时间为24个月。两组患者随访时间内总死亡率(4.9%VS 4.2%)、心源性死亡率(3.6%VS 1.9%)以及脑血管意外事件的发生率(6.2%VS 5.2%)差异无统计学意义(P0.05)。PCI组再发心肌梗死的发生率(4.0%)高于CABG组(0.9%),P0.05,且PCI组再次血运重建的发生率(19.1%)、MACCA发生率(28.9%)及再发心绞痛的发生率(30.2%)均明显高于CABG组(分别为1.4%、10.4%、6.1%),差异具有显著性意义(P0.001)。结论:冠心病多支血管病变PCI组与CABG组患者术后随访时间内死亡率无明显差异,但PCI组患者术后MACCA和再次血运重建的发生率均明显高于CABG组。
[Abstract]:Objective: to compare and evaluate the clinical effect and prognosis of two kinds of revascularization methods: percutaneous coronary stenting (PCI) and coronary artery bypass grafting (CABG) in patients with multivessel coronary artery disease (MVD). Methods: from January 2012 to December 2015, 437 patients with MVD underwent the first revascularization therapy in the first affiliated Hospital of Anhui Medical University. The baseline data of the two groups were compared during perioperative period. The primary endpoint events of the two groups included total death, cardiac death, and recurrent myocardial infarction. The incidence of major cardiovascular and cerebrovascular malfunction accidents such as cerebrovascular accidents and revascularization, and secondary terminal events, namely, recurrent angina pectoris. Results: all the patients were followed up. The follow-up rate was 100 and the average follow-up time was 24 months. There was no significant difference in the total mortality rate of 4. 9% vs 4. 2%, cardiac death rate 3. 6 vs 1. 9% and the incidence of cerebrovascular accidents in the 2 groups during the follow-up period (P 0. 05. 5. 2 vs 5. 2) there was no significant difference in the incidence of recurrent myocardial infarction in the PCI group. The incidence of recurrent angina pectoris in the PCI group was significantly higher than that in the CABG group (1.4%, 10.4%, P 0.01), and the difference was significant (P 0.001). Conclusion: the incidence of revascularization in the PCI group is significantly higher than that in the CABG group (P < 0.01). Conclusion: the incidence of revascularization in the PCI group is significantly higher than that in the CABG group (P 0.05). Conclusion: the incidence of recurrent angina pectoris in the PCI group is significantly higher than that in the CABG group (1.4 + 10.4%, P 0.05). Conclusion: there is a significant difference between the two groups. There was no significant difference in postoperative mortality between PCI group and CABG group. But the incidence of MACCA and revascularization in PCI group was significantly higher than that in CABG group.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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