本文選題：血運重建 + 冠狀動脈介入　； 參考：《廣東醫(yī)學》2017年09期

【摘要】：目的比較完全性血運重建及部分性血運重建對存在包括前降支在內雙支病變的缺血性心肌病(ICM)患者的療效。方法 112例經(jīng)選擇性冠狀動脈造影(SCAG)證實存在包括前降支在內雙支病變的ICM患者行冠狀動脈介入(PCI)治療,按是否在前降支行支架植入血運重建基礎上對另一支病變冠脈(回旋支或右冠狀動脈)行血運重建分為完全性血運重建組(完全重建組)及部分性血運重建組(部分重建組)各56例。術后隨訪1年,比較兩組PCI術中并發(fā)癥發(fā)生率、術前和術后1年的血漿B型利鈉肽(BNP)濃度、左心室舒張末期內徑(LVDd)、左心室射血分數(shù)(LVEF)及心血管不良事件發(fā)生率。結果部分重建組PCI術中并發(fā)癥發(fā)生率低于完全重建組,差異有統(tǒng)計學意義(P0.05);兩組術后1年的血漿BNP濃度較術前降低,LVDd較術前減小,而LVEF較術前增加,差異均有統(tǒng)計學意義(P0.05);但兩組之間術前和術后1年的血漿BNP濃度、LVDd及LVEF比較,差異均無統(tǒng)計學意義(P0.05);兩組心血管不良事件發(fā)生率比較,差異均無統(tǒng)計學意義(P0.05)。結論對于存在包括前降支在內雙支病變的ICM患者,前降支選擇性部分血運重建及完全性血運重建均能有效改善患者的心功能,且前者PCI術中并發(fā)癥發(fā)生率更低。
[Abstract]:Objective to compare the efficacy of complete revascularization and partial revascularization in patients with ischemic cardiomyopathy with double vessel disease including anterior descending branch. Methods one hundred and twelve patients with ICM confirmed by selective coronary angiography (SCAGG) were treated with coronary intervention (PCI). According to whether or not the anterior descending branch stent was used to reconstruct the blood flow of another diseased coronary artery (circumflex artery or right coronary artery), the patients were divided into complete revascularization group (complete reconstruction group) and partial revascularization group (P < 0.05). Partial reconstruction group (56 cases each). The incidence of complications, plasma B-type natriuretic peptide, left ventricular end-diastolic diameter, left ventricular ejection fraction and cardiovascular adverse events were compared between the two groups. Results the incidence of intraoperative complications in partial reconstruction group was lower than that in complete reconstruction group, the difference was statistically significant (P 0.05), the plasma BNP concentration in both groups was lower than that before operation, and the LVEF level was higher than that before operation. The difference was statistically significant (P 0.05), but there was no significant difference in plasma BNP concentration and LVEF between the two groups before operation and one year after operation, and there was no significant difference in the incidence of cardiovascular adverse events between the two groups (P 0.05). Conclusion selective partial revascularization of anterior descending branch and complete revascularization of anterior descending branch can effectively improve cardiac function in patients with ICM with double vessel disease including anterior descending branch, and the incidence of complications in the former PCI is lower.
【作者單位】： 汕頭市中心醫(yī)院心血管內科;
【基金】：汕頭市醫(yī)療科技計劃項目(編號:汕府科[2014]62號-14)
【分類號】：R542.2

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