CAJ | 학술논문

目的：探讨衰减斑块(AP)对急性冠脉综合征(ACS)患者冠状动脉介入治疗(PCI)近期和远期预后的影响。方法试验设计属于前瞻性研究,以2009年1月-2011年12月期间入住心内科且符合条件的225例 ACS患者为研究对象。记录一般临床资料、斑块的血管内超声特点、冠脉造影血流情况和PCI后30 d内心血管并发症。长期随访以电话随访为主,辅以住院随访、门诊随访,终点事件为主要不良心脏事件。生存率估算应用Kaplan-Meier法,组间生存率曲线差异采用 Log-Rank检验。结果 AP 组的血管外弹力膜面积(EEMA)、斑块面积(PA)、斑块负荷、重构指数均较非 AP组显著增大,两组之间球囊扩张后即刻校正的 TIMI帧数(CTFC)差异具有统计学意义(P <0.05)。AP组近期总并发症发生率显著高于非 AP组,但是长期随访后两组之间无不良心脏事件生存曲线比较差异无统计学意义(χ2=0.219,P =0.640)。结论 AP不影响PCI后 ACS患者的长期预后,但是影响其近期预后,这有助于 ACS患者急性期进一步的风险分层和指导治疗。
목적：탐토쇠감반괴(AP)대급성관맥종합정(ACS)환자관상동맥개입치료(PCI)근기화원기예후적영향。방법시험설계속우전첨성연구,이2009년1월-2011년12월기간입주심내과차부합조건적225례 ACS환자위연구대상。기록일반림상자료、반괴적혈관내초성특점、관맥조영혈류정황화PCI후30 d내심혈관병발증。장기수방이전화수방위주,보이주원수방、문진수방,종점사건위주요불양심장사건。생존솔고산응용Kaplan-Meier법,조간생존솔곡선차이채용 Log-Rank검험。결과 AP 조적혈관외탄력막면적(EEMA)、반괴면적(PA)、반괴부하、중구지수균교비 AP조현저증대,량조지간구낭확장후즉각교정적 TIMI정수(CTFC)차이구유통계학의의(P <0.05)。AP조근기총병발증발생솔현저고우비 AP조,단시장기수방후량조지간무불양심장사건생존곡선비교차이무통계학의의(χ2=0.219,P =0.640)。결론 AP불영향PCI후 ACS환자적장기예후,단시영향기근기예후,저유조우 ACS환자급성기진일보적풍험분층화지도치료。
Objective To explore the effect on prognosis of attenuated plaque (AP)in patients with acute coronary syndrome (ACS)after percutaneous coronary intervention(PCI).Methods This study was a prospective study which included 225 ACS patients who admitted to the cardiology and met the conditions between January 2009 and December 2011.Clinical data,intravascular ultrasound characteristics of plaque, blood flow in coronary angiography and cardiovascular complications within 30 days after PCI were recorded.The main form of follow-up was telephone follow-up,supplemented by patient follow-up and out-patient follow-up.Endpoint was major adverse cardiac events (MACE).Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared using the Log-Rank test.Results Extravascular elastic membrane area (EEMA),plaque area (PA),plaque burden,remodeling index in AP group were significantly increased than those in non-AP group.Corrected TIMI frame count (CTFC)immediately after the balloon dilatation was significantly higher in AP group than in non-AP group. Recent overall complications were more frequently documented in AP group than in non-AP group,but long-term follow-up outcome of MACE-free survival curves showed no significant difference between the two groups.Conclusions Recent prognosis,not long-term prognosis,is affected by attenuated plaque in ACS patients after PCI,which help to stratify risk further and guide treatment in ACS patients.