CAJ | 학술논문

目的观察冠状动脉介入治疗和单纯药物治疗对冠状动脉旁路移植术后再发心绞痛患者预后的影响.方法回顾性分析冠状动脉旁路移植术后因再发心绞痛行冠状动脉造影检查的患者的临床资料,依据是否对桥血管和原发冠状动脉病变进行介入性血运重建分为介入治疗组(129例)和单纯药物治疗组(133例).随访1年后的主要心血管事件发生率.主要终点为主要不良心血管事件(MACE)发生情况,包括心源性死亡、非致命性心肌梗死、靶病变/靶血管血运重建等;次要终点:非靶血管血运重建和心绞痛复发情况.观察心功能和因心血管疾病再住院率.结果随访1年,2组患者共成功随访245例,其中介入治疗组124例、药物治疗组121例.1年后MACE发生率:介入治疗组、药物治疗组分别为9.7％ (12/124)、23.1％(28/121),差异有统计学意义(P＜0.05).介入治疗组和药物治疗组心绞痛复发率为14.5％(18/124)和27.3％ (33/121),差异有统计学意义(P＜0.05).因心血管疾病再住院率介入治疗组和药物治疗组分别为10.5 (13/124)和21.5％ (26/121),差异有统计学意义(P＜0.01).介入治疗组左心室射血分数为(64±11)％,明显高于药物治疗组[(58±8)％](P＜0.05).结论经皮冠状动脉介入治疗对冠状动脉旁路移植术后桥血管和原发冠状动脉病变安全有效,中期预后优于单纯药物治疗.
목적 관찰관상동맥개입치료화단순약물치료대관상동맥방로이식술후재발심교통환자예후적영향.방법 회고성분석관상동맥방로이식술후인재발심교통행관상동맥조영검사적환자적림상자료,의거시부대교혈관화원발관상동맥병변진행개입성혈운중건분위개입치료조(129례)화단순약물치료조(133례).수방1년후적주요심혈관사건발생솔.주요종점위주요불양심혈관사건(MACE)발생정황,포괄심원성사망、비치명성심기경사、파병변/파혈관혈운중건등;차요종점:비파혈관혈운중건화심교통복발정황.관찰심공능화인심혈관질병재주원솔.결과 수방1년,2조환자공성공수방245례,기중개입치료조124례、약물치료조121례.1년후MACE발생솔:개입치료조、약물치료조분별위9.7％ (12/124)、23.1％(28/121),차이유통계학의의(P＜0.05).개입치료조화약물치료조심교통복발솔위14.5％(18/124)화27.3％ (33/121),차이유통계학의의(P＜0.05).인심혈관질병재주원솔개입치료조화약물치료조분별위10.5 (13/124)화21.5％ (26/121),차이유통계학의의(P＜0.01).개입치료조좌심실사혈분수위(64±11)％,명현고우약물치료조[(58±8)％](P＜0.05).결론 경피관상동맥개입치료대관상동맥방로이식술후교혈관화원발관상동맥병변안전유효,중기예후우우단순약물치료.
Objective To study percutaneous intervention and simple drug therapy of angina pectoris after coronary artery bypass grafting(CABG).Methods All 262 cases with angina pectoris after CABG were divided into percutaneous transluminal coronary intervention(PCI)group(n =129) and simple drug therapy group(drug group)(n =133).The incidence of major adverse cardiovascular events(MACE),revascularization of non-target vessels,cardic function and eardie readmission rate after 1 year were followed up.Results Of 262 patients with angina pectoris after CABG,245 cases were followed up successfully,and 124 cases were in PCI group,the other 121 cases were in drug group.The incidence rate of MACE in PCI group[9.7％(12/124) ] was higher than that in drug group [ 23.1％(28/121)](P ＜ 0.05).Rate of angina reocurrence in PCI group and drug group was 14.5％(18/124) and 27.3％(33/121)(P ＜ 0.01).Rate of readmission for cardiac events in PCI group and drug group was 10.5％(13/124) and 21.5 ％(26/121)(P ＜ 0.01).Left ventricular ejection fraction in PCI group was higher than that in drug group[(64±l 1)％ vs(58±8)％,P ＜0.05 ].Conclusion Percutaneous intervention is effective and safe for the patients with angina pectoris post-CABG and can improve clinical prognosis.