CAJ | 학술논문

目的比较左心室功能不全的冠心病患者经皮冠状动脉介入治疗(PCI)支架术与冠状动脉旁路移植术(CABG)对住院与临床随访结果的影响.方法 147例左心室功能不全的冠心病患者,根据血运重建方式的不同将其分为PCI组(60例)和CABG组(87例),记录其,临床与冠状动脉造影特征、血运重建情况和住院,临床结果等资料,并进行临床随访.主要观察终点为住院与随访主要不良心脑血管事件(MACCE)(包括全因死亡、新发心肌梗死、卒中和再次血运重建).所有资料采用SPSS 13.0软件进行统计分析,以P＜0.05为差异有统计学意义.结果 PCI组和CABG组相比,院内MACCE发生率差异无统计学意义(1.7%与9.2%,P＞0.05);院内病死率差异无统计学意义(1.7%与8.0%,P＞o.05).多因素Logistic回归分析表明,院内MACCE风险相当(OR=3.03,95%C/0.27～34.48,P＞0.05).平均随访22个月(中位数时间668 d)显示,2组MACCE发生率差异无统计学意义(16.0%与13.8%,P＞0.05),再次血运重建差异均无统计学意义(8.0%与1.7%,P＞0.05).多因素Cox回归分析显蟊,2组随访MACCE风险基本相当(HR=1.35,95%CI 0.44～4.13,P＞0.05).结论合并左心室功能不全的冠心病患者,PCI支架术与CABG的住院及随访MACCE发生率均相当.随着药物洗脱支架的广泛应用,PCI术的远期效果有望进一步提高.
목적 비교좌심실공능불전적관심병환자경피관상동맥개입치료(PCI)지가술여관상동맥방로이식술(CABG)대주원여림상수방결과적영향.방법 147례좌심실공능불전적관심병환자,근거혈운중건방식적불동장기분위PCI조(60례)화CABG조(87례),기록기,림상여관상동맥조영특정、혈운중건정황화주원,림상결과등자료,병진행림상수방.주요관찰종점위주원여수방주요불양심뇌혈관사건(MACCE)(포괄전인사망、신발심기경사、졸중화재차혈운중건).소유자료채용SPSS 13.0연건진행통계분석,이P＜0.05위차이유통계학의의.결과 PCI조화CABG조상비,원내MACCE발생솔차이무통계학의의(1.7%여9.2%,P＞0.05);원내병사솔차이무통계학의의(1.7%여8.0%,P＞o.05).다인소Logistic회귀분석표명,원내MACCE풍험상당(OR=3.03,95%C/0.27～34.48,P＞0.05).평균수방22개월(중위수시간668 d)현시,2조MACCE발생솔차이무통계학의의(16.0%여13.8%,P＞0.05),재차혈운중건차이균무통계학의의(8.0%여1.7%,P＞0.05).다인소Cox회귀분석현모,2조수방MACCE풍험기본상당(HR=1.35,95%CI 0.44～4.13,P＞0.05).결론 합병좌심실공능불전적관심병환자,PCI지가술여CABG적주원급수방MACCE발생솔균상당.수착약물세탈지가적엄범응용,PCI술적원기효과유망진일보제고.
Objective To compare the in-hospital and follow-up clinical results of percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG)in patients of left ventricular dysfunction with coronary artery disease.Methods 147 patients with left ventricular dysfunction were divided into PCI group(n=60)and CABG group(n=87).Clinical,angiographic and revascularization data were collected for analysis.Patients were by SPSS 13.0 software.P value of less than 0.05 was considered statistically significant.Results In-hospital MACCE rates and mortality ofthe two groups were comparable[(6.7%vs 9.2%,P＞0.05)and(1.7%vs 8.0%,P＞0.05)].Multivariate Logistic regression analysis indicated that in-hospital MACCE risk of the two groups were similar(OR≥3.03,95%CI 0.27～34.48,P＞0.05).22-month follow-up showed no signficance in MACCE rates (16.0%vs 13.8%,P＞0.05)and in repeated revaseularization rates(8.O%vs 1.7%,P＞0.05)between the two groups.Multivariate Cox regression analysis indicated that follow-up MACCE risk of the two groups were comparable (HR≥1.35,95%C/0.44～4.13,P＞0.05).Conclusion In coronary artery disease patients with left ventricular dysfunction,PCI and CABG have similar in-hospital and long-tem MACCE rates.Long-terra effect of PCI would be further increased with the wide use of drug-eluting stents.