超高龄冠心病患者危险因素与冠状动脉病变特点相关性分析.docVIP

冠状动脉长病变介入治疗疗效观察研究 倪飞华1，3 邬盛昌2 吴锋3 王飞宇3 秦永文3* [摘要] 目的 评价冠状动脉长病变置入长支架治疗的有效性及安全性。方法 回顾性分析2011年6月-2012年5月在我院行经皮冠状动脉介入治疗（percutaneous coronary interventionology, PCI）的418例冠心病（Coronary Heart Disease, CHD）患者的临床资料，其中短病变组（植入支架〈20mm）124例，长病变组（植入支架21-28mm、29-36mm及重叠植入支架）294例，比较两组PCI术中特点、术中急性并发症及随访12-18个月的心脏主要不良事件（major adverse cardiac events, MACE）情况。结果 与短病变组相比，围术期肌钙蛋白升高率（68.97% vs 44.19%）、球囊预扩张比例（64.63% vs 48.39%）、球囊后扩张比例（40.48% vs 20.97%）、非ST段抬高心肌梗死比例（9.52% vs 4.03%）、Gensini积分（32.93±21.49 vs 28.26±19.05）、术中急性分支闭塞/分支血管开口狭窄加重发生率（15.31% vs 8.06%），长病变组（32.16±11.68mm）显著高于短病变组（16.62±1.89mm）（P值0.05）；不稳定性心绞痛比率（44.56% vs 48.39%）长病变组显著低于短病变组（P值0.05），随访两组MACE事件发生率无明显差异。结论 冠状动脉长支架置入手术难度大，操作复杂，易出现术中并发症，但长支架置入后近中期疗效佳且安全。 关键词：冠心病；长病变；药物洗脱支架 Clinical Observation Research of Percutaneous Coronary Intervention for Long Lesions Ni Feihua1，3, Wu Shengchang2, Wu Feng3, Wang Feiyu3, Qin Yongwen3* 1：International medical center, Zhejiang provincial people’s Hospital, Hangzhou, China 2：Department of Respiration, Zhejiang provincial people’s Hospital, Hangzhou, China 3：Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China [Abstract] Objectives To evaluate the efficacy and safty of Percutaneous Coronary Intervention for Long Lesions. Methods A total of 418 cases who are admitted to CHANGHAI hospital between June 2011 and June 2012, and who underwent percutaneous coronary interventionology were selected in this study. They were divided into short coronary lesions group(20mm, n=124), long coronary lesions group(21-28mm, 29-36mm, overlap stent, n=294). Characteristics of PCI, complication and MACE were compared between the two groups. Results Compared with the short lesions group(16.62±1.89mm), there was significant higher in the perioperative troponin-I positive rate 68.97% v 44.19%, proportion of advanced ballon dilation 64.63% vs 48.39%, proportion of subsequent ballon dilation 40.48% vs 20.97%, proportion of non-ST segment elevation myocardial infarction