| 李月蕊 张辉 刘洋 肖湖南 刘宏斌.血运重建程度与不稳定心绞痛患者经皮冠状动脉介入术后早期预后的相关性[J].现代生物医学进展英文版,2015,15(18):3487-3491. |
| 血运重建程度与不稳定心绞痛患者经皮冠状动脉介入术后早期预后的相关性 |
| The Relationship between Revascularization Extent and the Short-termPrognosis of Patients with Unstable Angina Pectoris and Three-VesselDisease Treated by Percutaneous Coronary Intervention |
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| DOI： |
| 中文关键词: 冠心病 SYNTAX 评分 残余SYNTAX积分 血运重建程度 |
| 英文关键词: Coronary artery disease SYNTAX score Residual SYNTAX score Revascularization extent |
| 基金项目:全军医药卫生科研基金项目（11BJZ19） |
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| 中文摘要: |
| 目的：探讨合并左主干/ 三支病变的不稳定型心绞痛患者的血运重建程度（revascularization extent，RE）及其早期预后的关
系。方法：回顾性分析自2012 年1 月1 日-2012 年12 月31 日期间就诊于解放军总医院心血管内科行经皮冠状动脉介入术
（Percutaneous Coronary Intervention，PCI）的不稳定型心绞痛患者201 例，按其血运重建程度分为三组：低血运重建程度组(Low
RE group，RE≤ 65%)，中等血运重建程度组(MediumRE group，65%＜RE＜85%)，高血运重建程度组(High RE group，RE≥ 85%)，
比较三组患者PCI术后主要不良心脑血管事件（Major Adverse Cardiac and Cerebral Events,MACCE）的发生情况。结果：血运重建
程度RE是不稳定型心绞痛合并左主干/三支病变患者MACCE 及再次血运重建的独立预测因子；随着RE 的降低，不稳定型心
绞痛合并左主干/三支病变患者MACCE（25.0%、9.1%、6.0%，log-rank p=0.002）及再次血运重建（22.1%、7.6%、4.5%，log-rank p=0.
002）的发生率增加，而其死亡率及再梗死率的差异无统计学意义（P＞0.05）。结论：不稳定型心绞痛合并多支血管病变的患者，可
行完全再血管化治疗，以减少术后早期再血管化事件率及MACCE 事件发生率。 |
| 英文摘要: |
| Objective:To explore the relationship between revascularization extent (RE) and the short-term prognosis of patients
with three-vessel or left-main coronary artery disease undergoing percutaneous coronary intervention.Methods:From Jan. 2012 to Dec.
2012, clinical data of patients with three-vessel or left-main coronary artery disease undergoing PCI were collected. These patients were
divided into tertiles according to RE: Low RE group(n=68, RE≤ 65%), Medium RE group(n=66，65%＜RE＜85%), and High RE group
(n=67, RE≥ 85%). The primary end point was major adverse cardiac and cerebral events (MACCE). Cox proportional hazard regression
analyses were performed to evaluate the relation between RE and the incidence of MACCE.Results:At 17-month follow up，the rate of
MACCE significantly increased among patients in the low RE group (25.0%, P=0.005) as compared with those with the high RE group
(6.0%) or medium RE group (9.1%, P=0.017). The incidence of unplanned repeat revascularization decreased significantly as RE
increased (22.1%, 7.6%, 4.5%, log-rank p=0.002).Conclusion:Higher degree of revascularization by PCI in patients with 3-vessel or
left-main disease presenting with unstable angina can achieve better short-term clinical outcome compared with lower degree of
revascularization. |
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