完全与部分血运重建对双支病变的缺血性心肌病患者的疗效影响比较

发布时间：2018-05-15 21:27

本文选题：血运重建 + 冠状动脉介入　；参考：《广东医学》2017年09期

【摘要】：目的比较完全性血运重建及部分性血运重建对存在包括前降支在内双支病变的缺血性心肌病(ICM)患者的疗效。方法 112例经选择性冠状动脉造影(SCAG)证实存在包括前降支在内双支病变的ICM患者行冠状动脉介入(PCI)治疗,按是否在前降支行支架植入血运重建基础上对另一支病变冠脉(回旋支或右冠状动脉)行血运重建分为完全性血运重建组(完全重建组)及部分性血运重建组(部分重建组)各56例。术后随访1年,比较两组PCI术中并发症发生率、术前和术后1年的血浆B型利钠肽(BNP)浓度、左心室舒张末期内径(LVDd)、左心室射血分数(LVEF)及心血管不良事件发生率。结果部分重建组PCI术中并发症发生率低于完全重建组,差异有统计学意义(P0.05);两组术后1年的血浆BNP浓度较术前降低,LVDd较术前减小,而LVEF较术前增加,差异均有统计学意义(P0.05);但两组之间术前和术后1年的血浆BNP浓度、LVDd及LVEF比较,差异均无统计学意义(P0.05);两组心血管不良事件发生率比较,差异均无统计学意义(P0.05)。结论对于存在包括前降支在内双支病变的ICM患者,前降支选择性部分血运重建及完全性血运重建均能有效改善患者的心功能,且前者PCI术中并发症发生率更低。
[Abstract]:Objective to compare the efficacy of complete revascularization and partial revascularization in patients with ischemic cardiomyopathy with double vessel disease including anterior descending branch. Methods one hundred and twelve patients with ICM confirmed by selective coronary angiography (SCAGG) were treated with coronary intervention (PCI). According to whether or not the anterior descending branch stent was used to reconstruct the blood flow of another diseased coronary artery (circumflex artery or right coronary artery), the patients were divided into complete revascularization group (complete reconstruction group) and partial revascularization group (P < 0.05). Partial reconstruction group (56 cases each). The incidence of complications, plasma B-type natriuretic peptide, left ventricular end-diastolic diameter, left ventricular ejection fraction and cardiovascular adverse events were compared between the two groups. Results the incidence of intraoperative complications in partial reconstruction group was lower than that in complete reconstruction group, the difference was statistically significant (P 0.05), the plasma BNP concentration in both groups was lower than that before operation, and the LVEF level was higher than that before operation. The difference was statistically significant (P 0.05), but there was no significant difference in plasma BNP concentration and LVEF between the two groups before operation and one year after operation, and there was no significant difference in the incidence of cardiovascular adverse events between the two groups (P 0.05). Conclusion selective partial revascularization of anterior descending branch and complete revascularization of anterior descending branch can effectively improve cardiac function in patients with ICM with double vessel disease including anterior descending branch, and the incidence of complications in the former PCI is lower.
【作者单位】：汕头市中心医院心血管内科;
【基金】：汕头市医疗科技计划项目(编号:汕府科[2014]62号-14)
【分类号】：R542.2

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