冠脉搭桥与支架置入治疗冠心病多支病变预后评价.docVIP

冠脉搭桥与支架置入治疗冠心病多支病变预后评价 　　摘要：目的 比较冠心病多支血管病变（MVD）患者冠状动脉旁路移植术（CABG）与经皮冠状动脉介入治疗（PCI）两种再血管化方式的临床预后。方法 入选2013年1月～2015年12月在本院首次行血运重建术的MVD患者437例，其中CABG组212例，PCI组225例。比较两组患者围术期基线特征，随访观察两组主要终点事件的发生率，包括死亡、心源性死亡、心肌梗死、脑血管意外及再次血运重建等主要不良心脑血管意外（MACCE），次要终点事件再发心绞痛的发生率。对比分析两种血运重建方式的预后。结果 两组患者死亡率、心源性死亡率、脑血管意外发生率无统计学差异（P0.05），PCI组MACCE发生率、心肌梗死发生率、再次血运重建发生率及心绞痛复发率均明显高于CABG组，差异有统计学意义（P0.05～0.001）。结论 两组患者死亡率无明显差异，但CABG组患者术后MACCE及再次血运重建发生率低于PCI组。 　　关键词：冠心病；多支血管病变；冠状动脉旁路移植术；经皮冠状动脉介入治疗 　　Evaluation of Coronary Artery Bypass Grafting and Stent Implantation in the Treatment of Coronary Artery Disease 　　CAO Jing，KONG Xiang，GE Jian-jun 　　（Department of Cardiology，the First Affiliated Hospital of Anhui Medical University，Hefei 230022，Anhui，China） 　　Abstract：Objective To compare the coronary multivessel disease（MVD）patients after coronary artery bypass grafting（CABG）and percutaneous coronary intervention（PCI）clinical prognosis of two revascularization.Methods 437 MVD patients selected in January 2013～2015 year in December in our hospital for the first time to revascularization of patients，including 212 in group CABG cases，225 cases in PCI group.Compared with two groups of patients with baseline characteristics of operation period，follow-up rate，two groups of end point events including death，cardiac death，myocardial infarction，cerebrovascular accident and revascularization of major adverse cardiovascular and cerebrovascular accident（MACCE），the incidence of recurrent angina secondary end point events the prognosis of angina pectoris.Comparative analysis of two kinds of mode of revascularization.Results Two groups of patients，mortality，cardiac death，cerebrovascular accident rate showed no significant difference（P0.05），the incidence of PCI in group MACCE，the incidence of myocardial infarction，revascularization the recurrence rate of angina and the occurrence rate was obviously higher than that of group CABG，the difference was statistically significant（P0.05～0.001）.Conclusion There is no signifi