本文選題：血運(yùn)重建 + 冠狀動(dòng)脈介入�。� 參考：《廣東醫(yī)學(xué)》2017年09期

【摘要】：目的比較完全性血運(yùn)重建及部分性血運(yùn)重建對(duì)存在包括前降支在內(nèi)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(dòng)脈造影(SCAG)證實(shí)存在包括前降支在內(nèi)雙支病變的ICM患者行冠狀動(dòng)脈介入(PCI)治療,按是否在前降支行支架植入血運(yùn)重建基礎(chǔ)上對(duì)另一支病變冠脈(回旋支或右冠狀動(dòng)脈)行血運(yùn)重建分為完全性血運(yùn)重建組(完全重建組)及部分性血運(yùn)重建組(部分重建組)各56例。術(shù)后隨訪1年,比較兩組PCI術(shù)中并發(fā)癥發(fā)生率、術(shù)前和術(shù)后1年的血漿B型利鈉肽(BNP)濃度、左心室舒張末期內(nèi)徑(LVDd)、左心室射血分?jǐn)?shù)(LVEF)及心血管不良事件發(fā)生率。結(jié)果部分重建組PCI術(shù)中并發(fā)癥發(fā)生率低于完全重建組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組術(shù)后1年的血漿BNP濃度較術(shù)前降低,LVDd較術(shù)前減小,而LVEF較術(shù)前增加,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);但兩組之間術(shù)前和術(shù)后1年的血漿BNP濃度、LVDd及LVEF比較,差異均無統(tǒng)計(jì)學(xué)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(jì)學(xué)意義(P0.05)。結(jié)論對(duì)于存在包括前降支在內(nèi)雙支病變的ICM患者,前降支選擇性部分血運(yùn)重建及完全性血運(yùn)重建均能有效改善患者的心功能,且前者PCI術(shù)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(nèi)科;
【基金】：汕頭市醫(yī)療科技計(jì)劃項(xiàng)目(編號(hào):汕府科[2014]62號(hào)-14)
【分類號(hào)】：R542.2

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