CAJ | 학술논문

目的　探讨经皮冠状动脉腔内成形术(PTCA)和PTCA＋支架治疗对我国冠心病患者的远期疗效。方法　对自1986年12月至1998年6月期间在我院接受PTCA和PTCA＋支架治疗的938例中的790例患者进行了随访，随访率84.2%。随访方式包括门诊随访和信访。随访时间为0.9-12.7年(平均3.5±2.4年)。结果　随访期中死亡4例(0.51%),非致命性急性心肌梗塞22例(2.8%)，重复PTCA 98例(12.4%)，行冠状动脉旁路移植术10例(1.3%)。以Kaplan-Meier 法计算术后12年的生存率为99.5% ,无心脏事件生存率1年为88.2%，12年为80.6%。Cox回归分析显示，陈旧性心肌梗死病史和是否放置支架与心脏事件呈负相关，而病变支数与心脏事件正相关。与单纯PTCA组比较， PTCA＋支架组急性心肌梗死发生率和再次PTCA率均显著低于前者。结论　PTCA，特别是PTCA＋支架治疗对我国冠心病患者有良好的疗效，可作为血管重建治疗的首选方法。
목적　탐토경피관상동맥강내성형술(PTCA)화PTCA＋지가치료대아국관심병환자적원기료효。방법　대자1986년12월지1998년6월기간재아원접수PTCA화PTCA＋지가치료적938례중적790례환자진행료수방，수방솔84.2%。수방방식포괄문진수방화신방。수방시간위0.9-12.7년(평균3.5±2.4년)。결과　수방기중사망4례(0.51%),비치명성급성심기경새22례(2.8%)，중복PTCA 98례(12.4%)，행관상동맥방로이식술10례(1.3%)。이Kaplan-Meier 법계산술후12년적생존솔위99.5% ,무심장사건생존솔1년위88.2%，12년위80.6%。Cox회귀분석현시，진구성심기경사병사화시부방치지가여심장사건정부상관，이병변지수여심장사건정상관。여단순PTCA조비교， PTCA＋지가조급성심기경사발생솔화재차PTCA솔균현저저우전자。결론　PTCA，특별시PTCA＋지가치료대아국관심병환자유량호적료효，가작위혈관중건치료적수선방법。
Objective To examine long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA),coronary stenting and to assess the factors affecting its efficacy. Methods A total of 790 patients who underwent successful PTCA and PTCA+stent in this hospital were followed by direct interview or letter. The rate of follow-up was 84.2% and the period of follow-up was 0.9-12.7 (3.5±2.4) years.Results During follow-up, 4 (0.5%) patients died, 22 (2.8%) had nonfatal acute myocardial infarction, 10 (1.3%) had coronary artery bypass surgery, and 98 (12.4%) had repeat PTCA. The rate of recurrent angina pectoris was 31.1%. The cardiac event-free survival rate calculated by the Kaplan-Meier method was 88.2% at 1 year and 80.6% at 12.7 years. Cox regression analysis showed that there was a positive correlation between AMI history, stent implantation and the risk of cardiac events, and there was a negative correlation between the number of diseased arteries and the risk of cardiac events. Compared to the PTCA group, patients with PTCA+stent had significantly lower rates of total cardiac events.Conclusion The long-term efficacy of PTCA, especially PTCA + stent in Chinese patients was very satisfactory, suggesting that PTCA+stent therapy should be the major treatment for revascularization in patients with coronary heart disease.