实用医学杂志
實用醫學雜誌
실용의학잡지
THE JOURNAL OF PRACTICAL MEDICINE
2014年
11期
1725-1729
,共5页
无保护左主干病变%危险分层%经皮冠脉介入术%冠状动脉搭桥术%Syntax积分
無保護左主榦病變%危險分層%經皮冠脈介入術%冠狀動脈搭橋術%Syntax積分
무보호좌주간병변%위험분층%경피관맥개입술%관상동맥탑교술%Syntax적분
Unprotected Left main coronary artery disease%Risk stratification%Percutaneous coronary intervention%Coronary artery bypass grafting%Syntax score
目的：比较无保护左主干病变（ULMCAD）患者分别行经皮冠脉介入治疗（PCI）及冠状动脉搭桥术（CABG）后的主要不良心脏事件（MACE）发生率及预测因子，并对行PCI患者进行危险分层。方法：分析201例行PCI或CABG治疗的ULMCAD患者的MACE发生率，统计分析得到影响MACE的预测因子。对PCI组中的预测因子进行赋值并分层，在另外126例病例中验证这种分层对预测MACE的有效性。结果：PCI及CABG组MACE发生率分别为16％及11．9％。PCI组中，LVEF、合并糖尿病、Syntax积分与MACE相关。CABG组中，年龄、LVEF及肾功能不全与MACE相关。验证结果表明依据LVEF、是否合并糖尿病及Syntax积分进行的危险分层对MACE发生率有较好的预测价值。结论：左主干病变行PCI可行且远期效果较好。依据LVEF、是否合并糖尿病及Syntax积分进行的危险分层对MACE发生率有较好的预测价值。
目的：比較無保護左主榦病變（ULMCAD）患者分彆行經皮冠脈介入治療（PCI）及冠狀動脈搭橋術（CABG）後的主要不良心髒事件（MACE）髮生率及預測因子，併對行PCI患者進行危險分層。方法：分析201例行PCI或CABG治療的ULMCAD患者的MACE髮生率，統計分析得到影響MACE的預測因子。對PCI組中的預測因子進行賦值併分層，在另外126例病例中驗證這種分層對預測MACE的有效性。結果：PCI及CABG組MACE髮生率分彆為16％及11．9％。PCI組中，LVEF、閤併糖尿病、Syntax積分與MACE相關。CABG組中，年齡、LVEF及腎功能不全與MACE相關。驗證結果錶明依據LVEF、是否閤併糖尿病及Syntax積分進行的危險分層對MACE髮生率有較好的預測價值。結論：左主榦病變行PCI可行且遠期效果較好。依據LVEF、是否閤併糖尿病及Syntax積分進行的危險分層對MACE髮生率有較好的預測價值。
목적：비교무보호좌주간병변（ULMCAD）환자분별행경피관맥개입치료（PCI）급관상동맥탑교술（CABG）후적주요불양심장사건（MACE）발생솔급예측인자，병대행PCI환자진행위험분층。방법：분석201례행PCI혹CABG치료적ULMCAD환자적MACE발생솔，통계분석득도영향MACE적예측인자。대PCI조중적예측인자진행부치병분층，재령외126례병례중험증저충분층대예측MACE적유효성。결과：PCI급CABG조MACE발생솔분별위16％급11．9％。PCI조중，LVEF、합병당뇨병、Syntax적분여MACE상관。CABG조중，년령、LVEF급신공능불전여MACE상관。험증결과표명의거LVEF、시부합병당뇨병급Syntax적분진행적위험분층대MACE발생솔유교호적예측개치。결론：좌주간병변행PCI가행차원기효과교호。의거LVEF、시부합병당뇨병급Syntax적분진행적위험분층대MACE발생솔유교호적예측개치。
Objective To compare the incidence of MACE and predictors in patients with unprotected left main coronary artery disease (ULMCAD) after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). To establish a risk stratification to guide treatment and prognosis of patients with ULMCAD who underwent PCI. Methods The incidence of MACE in 201 patients with ULMCAD who underwent PCI or CABG was compared, retrospectively. The predictors of MACE of the two groups were obtained by logistic regression analyses. The predictors of MACE of the PCI group were assigned and stratified. The validity of the risk stratification on the prediction of MACE was verified in a new group of 126 patients with ULMCAD who underwent PCI. Results The incidence of MACE of PCI and CABG group was 16% and 11.9%, respectively. Logistic regression analyses showed that LVEF, diabetes mellitus and Syntax score were related to MACE in PCI group, while age, LVEF and renal function insufficiency were related to MACE in CABG group. The verification results showed a good predictive value of the risk stratification based on LVEF, diabetes mellitus and Syntax score on the incidence of MACE. Conclusions PCI treatment in patients with ULMCAD is feasible and has a good long-term outcome. The risk stratification in accordance with LVEF, diabetes mellitus and Syntax score has good predictive value on the incidence of MACE.
