我院110例冠脉全程支架治疗冠状动脉弥漫性病变的长期疗效和安全性

发布时间：2018-04-23 08:40

本文选题：冠状动脉性心脏病 + 弥漫性病变　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:评估经皮冠状动脉介入治疗(PCI)病人中接受支架长度60mm的患者26~48个月后的主要不良心脏事件发生情况,探讨影响主要不良心脏事件发生的相关因素。方法:回顾性分析2013年2月至2014年12月在广西医科大学第一附属医院行支架长度60mm治疗的患者的临床资料,包括一般资料、病史资料与手术操作资料,在患者术后26~48个月通过电话、门诊或住院系统行临床随访调查,主要记录主要不良心脏事件(MACE)的发生情况,采用logistic回归分析与长支架术后主要不良心脏事件发生率相关的因素。结果:110例患者共有8例(7.27%)发生围手术期并发症,其中无MACE组7例(慢/无回流4例,支架血栓1例,夹层2例),MACE组1例(夹层1例),但两者无统计学差异(P=0.538)。随访发现31(28.18%)例患者发生主要不良心脏事件,其中心绞痛复发23例(20.91%)例,再次血运重建10(9.09%)例(6例靶血管血运重建和4例非靶血管血运重建),充血性心力衰竭3(2.72%)例,非致命性心肌梗死1(0.91%)例,心源性死亡1(0.91%)例。与无MACE的患者相比,有MACE的患者合并有脑血管疾病的可能性更大,术中使用到的支架数量更多,支架总长度更大。多因素分析显示合并脑血管疾病{风险比(OR)6.829,P=0.020},支架长度(OR 6.747,P=0.000)和支架数量(OR 2.199,P=0.012)是MACE的独立危险因素。结论:1、冠脉全程支架治疗冠状动脉弥漫性病变的安全性和长期疗效总体满意,安全可行。2、合并有脑血管疾病的患者更容易发生主要不良心脏事件。3、冠脉全程支架的长度和支架数量是与主要不良心脏事件发生率相关的重要预测因子。
[Abstract]:Objective: To evaluate the major adverse cardiac events in patients receiving stent length 60mm in percutaneous coronary intervention (PCI) patients after 26~48 months, and to explore the related factors affecting the major adverse cardiac events. Methods: a retrospective analysis of the length of stent length in the First Affiliated Hospital of Guangxi Medical University from February 2013 to December 2014. The clinical data of patients treated with 60mm, including general data, medical history data and operation data, were followed up by telephone, outpatient or hospitalization after 26~48 months after the operation. The major adverse cardiac events (MACE) were recorded, and logistic regression analysis and the major adverse cardiac events after long stenting were used. Results: in 110 patients, 8 cases (7.27%) had perioperative complications, of which there were no MACE group 7 cases (slow / non reflux 4 cases, 1 stent thrombosis, 2 dissection), and 1 cases (1 dissection) in group MACE, but there was no statistical difference (P=0.538). The major adverse cardiac events occurred in 31 (28.18%) patients and its angina pectoris occurred. 23 (20.91%) cases, revascularization in 10 (9.09%) cases (6 cases of target blood vessel revascularization and 4 non target vascular revascularization), 3 (2.72%) cases of congestive heart failure, 1 (0.91%) of non fatal myocardial infarction, 1 (0.91%) cases of cardiogenic death. Compared with those without MACE, patients with MACE were more likely to have cerebrovascular disease, and the operation was made in the operation. The number of scaffolds used was more and the total length of the stent was greater. Multivariate analysis showed that the risk ratio of cerebrovascular disease {risk ratio (OR) 6.829, P=0.020}, OR 6.747, P=0.000) and the number of stents (OR 2.199, P=0.012) were independent risk factors for MACE. Conclusion: 1, the safety and long-term treatment of coronary artery diffuse lesions by coronary artery stenting. Overall satisfaction, safe and feasible.2, patients with cerebrovascular disease are more likely to have major adverse cardiac events.3. The length of the stent and the number of stents are important predictors of the incidence of major adverse cardiac events.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R543.3

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