论文部分内容阅读
目的 探讨经皮冠状动脉介入治疗 (PCI)在不能耐受冠状动脉旁路移植术 (CABG)或手术高危的无保护左主干病变 (UPL MT)患者中的应用及近、远期疗效。方法 自 1993年 2月至 2 0 0 2年 8月期间 ,对 85例被列为不能耐受 CABG或手术高危的 UPL MT进行了 PCI治疗 ,其中定向斑块旋切术 (DCA) 4 8例 ,支架术 37例。术后半年内每月至少门诊复查一次 ,以后定期随诊、电话随访。术后 3、6、12月行冠状动脉造影复查。结果 PCI术均获技术成功(术后残余直径狭窄 <5 0 % ,且获得 TIMI3级血流 )。住院期间主要不良心脏事件 (MACE)共 12例 (14 .1% ) :死亡9例 (10 .6 % ) ,其中心源性死亡 3例 (3.5 % ) ;再次 PCI术 3例 (3.5 % ) ;无 Q波心肌梗死、急诊 CABG。术后半年随访发现死亡共 15例 (17.6 % ) ,其中心源性死亡 8例 (9.4 % ) ;半年内共有 71例患者接受冠状动脉造影复查 ,其中对19例 (2 6 .8% )进行了靶血管重建 ;对资料完整的 6 4例患者作左心室射血分数 (L VEF)对比分析 ,结果显示 :PCI术后 (3或 /和 6个月 ) L VEF较术前显著改善 (5 .5± 8.7% ,P<0 .0 5 )。Kaplan- Meier生存分析显示 :PCI术后 1年、3年 (免于死亡 )的生存率为 81.2 %、76 .5 % ,免于心源性死亡的生存率为 90 .6 %、89.4 % ,免于心脏事件的生
Objective To investigate the short-term and long-term effects of percutaneous coronary intervention (PCI) in patients with unprotected left main disease (UPL) who can not tolerate coronary artery bypass grafting (CABG) or surgery. Methods From February 1993 to August 2002, 85 patients with UPL MT who were classified as intolerant CABG or surgery were enrolled in this study. 48 cases of directional plaque biopsy (DCA) , Stent in 37 cases. Within six months after surgery at least clinically reviewed once a month, after regular follow-up, telephone follow-up. Postoperative 3, 6, December coronary angiography review. Results Both PCI and PCI were successful (residual stenosis <50% and TIMI grade 3 blood flow). There were 12 cases (14.1%) of major adverse cardiac events (MACE) during hospitalization: 9 (10.6%) died and 3 (3.5%) cardiac deaths; 3 ; No Q wave myocardial infarction, emergency CABG. A total of 15 deaths (17.6%) were found after 6 months of follow-up, of which 8 (9.4%) were cardiac deaths. A total of 71 patients underwent coronary angiography within 6 months, of which 19 (26.8% (LVEF) in 64 patients with complete data. The results showed that LVEF was significantly improved after PCI (3 or 6 and 6 months) compared with that before operation (5 .5 ± 8.7%, P <0.05). Kaplan-Meier survival analysis showed that the survival rates at 1 year, 3 years (from death) after PCI were 81.2% and 76.5%, and the survival rates from cardiogenic death were 90.6% and 89.4% Health from heart attacks