本文選題：冠狀動(dòng)脈性心臟病 + 彌漫性病變�。� 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:評(píng)估經(jīng)皮冠狀動(dòng)脈介入治療(PCI)病人中接受支架長(zhǎng)度60mm的患者26~48個(gè)月后的主要不良心臟事件發(fā)生情況,探討影響主要不良心臟事件發(fā)生的相關(guān)因素。方法:回顧性分析2013年2月至2014年12月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院行支架長(zhǎng)度60mm治療的患者的臨床資料,包括一般資料、病史資料與手術(shù)操作資料,在患者術(shù)后26~48個(gè)月通過(guò)電話、門診或住院系統(tǒng)行臨床隨訪調(diào)查,主要記錄主要不良心臟事件(MACE)的發(fā)生情況,采用logistic回歸分析與長(zhǎng)支架術(shù)后主要不良心臟事件發(fā)生率相關(guān)的因素。結(jié)果:110例患者共有8例(7.27%)發(fā)生圍手術(shù)期并發(fā)癥,其中無(wú)MACE組7例(慢/無(wú)回流4例,支架血栓1例,夾層2例),MACE組1例(夾層1例),但兩者無(wú)統(tǒng)計(jì)學(xué)差異(P=0.538)。隨訪發(fā)現(xiàn)31(28.18%)例患者發(fā)生主要不良心臟事件,其中心絞痛復(fù)發(fā)23例(20.91%)例,再次血運(yùn)重建10(9.09%)例(6例靶血管血運(yùn)重建和4例非靶血管血運(yùn)重建),充血性心力衰竭3(2.72%)例,非致命性心肌梗死1(0.91%)例,心源性死亡1(0.91%)例。與無(wú)MACE的患者相比,有MACE的患者合并有腦血管疾病的可能性更大,術(shù)中使用到的支架數(shù)量更多,支架總長(zhǎng)度更大。多因素分析顯示合并腦血管疾病{風(fēng)險(xiǎn)比(OR)6.829,P=0.020},支架長(zhǎng)度(OR 6.747,P=0.000)和支架數(shù)量(OR 2.199,P=0.012)是MACE的獨(dú)立危險(xiǎn)因素。結(jié)論:1、冠脈全程支架治療冠狀動(dòng)脈彌漫性病變的安全性和長(zhǎng)期療效總體滿意,安全可行。2、合并有腦血管疾病的患者更容易發(fā)生主要不良心臟事件。3、冠脈全程支架的長(zhǎng)度和支架數(shù)量是與主要不良心臟事件發(fā)生率相關(guān)的重要預(yù)測(cè)因子。
[Abstract]:Objective: To evaluate the major adverse cardiac events in patients receiving stent length 60mm in percutaneous coronary intervention (PCI) patients after 26~48 months, and to explore the related factors affecting the major adverse cardiac events. Methods: a retrospective analysis of the length of stent length in the First Affiliated Hospital of Guangxi Medical University from February 2013 to December 2014. The clinical data of patients treated with 60mm, including general data, medical history data and operation data, were followed up by telephone, outpatient or hospitalization after 26~48 months after the operation. The major adverse cardiac events (MACE) were recorded, and logistic regression analysis and the major adverse cardiac events after long stenting were used. Results: in 110 patients, 8 cases (7.27%) had perioperative complications, of which there were no MACE group 7 cases (slow / non reflux 4 cases, 1 stent thrombosis, 2 dissection), and 1 cases (1 dissection) in group MACE, but there was no statistical difference (P=0.538). The major adverse cardiac events occurred in 31 (28.18%) patients and its angina pectoris occurred. 23 (20.91%) cases, revascularization in 10 (9.09%) cases (6 cases of target blood vessel revascularization and 4 non target vascular revascularization), 3 (2.72%) cases of congestive heart failure, 1 (0.91%) of non fatal myocardial infarction, 1 (0.91%) cases of cardiogenic death. Compared with those without MACE, patients with MACE were more likely to have cerebrovascular disease, and the operation was made in the operation. The number of scaffolds used was more and the total length of the stent was greater. Multivariate analysis showed that the risk ratio of cerebrovascular disease {risk ratio (OR) 6.829, P=0.020}, OR 6.747, P=0.000) and the number of stents (OR 2.199, P=0.012) were independent risk factors for MACE. Conclusion: 1, the safety and long-term treatment of coronary artery diffuse lesions by coronary artery stenting. Overall satisfaction, safe and feasible.2, patients with cerebrovascular disease are more likely to have major adverse cardiac events.3. The length of the stent and the number of stents are important predictors of the incidence of major adverse cardiac events.

【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R543.3

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