中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2011年
11期
980-983
,共4页
韩业晨%张抒扬%林松柏%沈珠军%范中杰%王崇慧%金晓峰%谢洪智%刘震宇%曾勇%方全
韓業晨%張抒颺%林鬆柏%瀋珠軍%範中傑%王崇慧%金曉峰%謝洪智%劉震宇%曾勇%方全
한업신%장서양%림송백%침주군%범중걸%왕숭혜%금효봉%사홍지%류진우%증용%방전
脑血管意外%血管成形术,经腔,经皮冠状动脉%治疗结果
腦血管意外%血管成形術,經腔,經皮冠狀動脈%治療結果
뇌혈관의외%혈관성형술,경강,경피관상동맥%치료결과
Cerebrovascular accident%Angioplasty,transluminal,peroutaneous coronary%Treatment outcome
目的 探讨接受经皮冠状动脉介入治疗(PCI)且既往有缺血性卒中史的冠心病患者的临床特点和长期随访的结果.方法 回顾性分析北京协和医院2003年1月至2007年12月连续行PCI的2053例患者的临床资料,并随访至2009年12月.随访终点事件包括全因死亡、心原性死亡、支架内血栓形成、靶病变再次血管重建、再次心肌梗死、脑梗死.统计随访期间患者主要出血事件的发生率.结果 共随访1945例冠心病患者,其中222例患者既往有缺血性卒中病史.与非缺血性卒中患者比较,有缺血性卒中史患者的年龄较大(P =0.000),高血压患病率(P=0.000)、糖尿病患病率(P =0.005)和多支病变(P=0.000)比例较高.患者随访时间为(35.0±19.6)个月.与非缺血性卒中患者比较,有缺血性卒中史患者的心原性死亡(8.5％比3.9％,P =0.002)、再次脑梗死(5.8％比1.4％,P =0.000)的发生率较高,服用双联抗血小板时间差异无统计学意义[(13.77±11.33)个月比(13.94±11.33)个月,P=0.986],主要出血事件的发生率差异无统计学意义(5.8％比3.6％,P=0.100),而脑出血的发生率较高(1.8％比0.5％,P=0.028).结论 与非缺血性卒中患者比较,既往有缺血性卒中史的冠心病患者有更高的危险因素患病率,冠状动脉受累的部位更多,随访期间心原性死亡和再次脑梗死的发生率更高,在不减少双联抗血小板治疗时间的情况下脑出血的发生率更高.
目的 探討接受經皮冠狀動脈介入治療(PCI)且既往有缺血性卒中史的冠心病患者的臨床特點和長期隨訪的結果.方法 迴顧性分析北京協和醫院2003年1月至2007年12月連續行PCI的2053例患者的臨床資料,併隨訪至2009年12月.隨訪終點事件包括全因死亡、心原性死亡、支架內血栓形成、靶病變再次血管重建、再次心肌梗死、腦梗死.統計隨訪期間患者主要齣血事件的髮生率.結果 共隨訪1945例冠心病患者,其中222例患者既往有缺血性卒中病史.與非缺血性卒中患者比較,有缺血性卒中史患者的年齡較大(P =0.000),高血壓患病率(P=0.000)、糖尿病患病率(P =0.005)和多支病變(P=0.000)比例較高.患者隨訪時間為(35.0±19.6)箇月.與非缺血性卒中患者比較,有缺血性卒中史患者的心原性死亡(8.5％比3.9％,P =0.002)、再次腦梗死(5.8％比1.4％,P =0.000)的髮生率較高,服用雙聯抗血小闆時間差異無統計學意義[(13.77±11.33)箇月比(13.94±11.33)箇月,P=0.986],主要齣血事件的髮生率差異無統計學意義(5.8％比3.6％,P=0.100),而腦齣血的髮生率較高(1.8％比0.5％,P=0.028).結論 與非缺血性卒中患者比較,既往有缺血性卒中史的冠心病患者有更高的危險因素患病率,冠狀動脈受纍的部位更多,隨訪期間心原性死亡和再次腦梗死的髮生率更高,在不減少雙聯抗血小闆治療時間的情況下腦齣血的髮生率更高.
목적 탐토접수경피관상동맥개입치료(PCI)차기왕유결혈성졸중사적관심병환자적림상특점화장기수방적결과.방법 회고성분석북경협화의원2003년1월지2007년12월련속행PCI적2053례환자적림상자료,병수방지2009년12월.수방종점사건포괄전인사망、심원성사망、지가내혈전형성、파병변재차혈관중건、재차심기경사、뇌경사.통계수방기간환자주요출혈사건적발생솔.결과 공수방1945례관심병환자,기중222례환자기왕유결혈성졸중병사.여비결혈성졸중환자비교,유결혈성졸중사환자적년령교대(P =0.000),고혈압환병솔(P=0.000)、당뇨병환병솔(P =0.005)화다지병변(P=0.000)비례교고.환자수방시간위(35.0±19.6)개월.여비결혈성졸중환자비교,유결혈성졸중사환자적심원성사망(8.5％비3.9％,P =0.002)、재차뇌경사(5.8％비1.4％,P =0.000)적발생솔교고,복용쌍련항혈소판시간차이무통계학의의[(13.77±11.33)개월비(13.94±11.33)개월,P=0.986],주요출혈사건적발생솔차이무통계학의의(5.8％비3.6％,P=0.100),이뇌출혈적발생솔교고(1.8％비0.5％,P=0.028).결론 여비결혈성졸중환자비교,기왕유결혈성졸중사적관심병환자유경고적위험인소환병솔,관상동맥수루적부위경다,수방기간심원성사망화재차뇌경사적발생솔경고,재불감소쌍련항혈소판치료시간적정황하뇌출혈적발생솔경고.
Objective To analyze the clinical characteristics and long-term outcomes of patients underwent percutaneous coronary intervention(PCI) with prior ischemic stroke.Methods A total of 2053 patients underwent PCI in Peking union medical college hospital from January 2003 to December 2007 were included in this analysis and patients were followed up to December 2009.End-point included all-cause mortality,cardiac death,stent thrombosis,target-lesion revascularization,myocardial infarction,re-cerebral infarction.Major bleeding events were recorded during follow-up.Results There are 1945 coronary heart disease patients were followed up and 222 patients with prior ischemic stroke.Compared patients without prior ischemic stroke,patients with prior ischemic stroke were older ( P = 0.000),had higher hypertension morbidity(P = 0.000 ),higher diabetes mellitus morbidity ( P = 0.005 ),higher incidence of multi-vessels disease( P = 0.000).During the follow-up of (35.0 ± 19.6) months,cardiac death rate( 8.5％ vs.3.9％,P=0.002)and re-cerebral infarction rate (5.8％ vs.1.4％,P=0.000) were higher in patients with prior ischemic stroke than patients without prior ischemic stroke.Dual antiplatelet therapy treatment time[ ( 13.77 ±11.33 ) months vs.( 13.94 ± 11.33 ) months,P = 0.986 ] and major bleeding events (5.8％ vs.3.6％,P =0.l00)were similar between the two groups and cerebral hemorrhage rate( 1.8％ vs.0.5％,P =0.028)were higher in patients with prior ischemic stroke than patients without prior ischemic stroke.Conclusion Patients with prior ischemic stroke were associated with increased rate of risk factors,multiple coronary artery disease,cardiac death and re-cerebral infarction and higher cerebral hemorrhage rate during follow-up despite similar dual-anti platelet therapy time.
