冠状动脉病变患者429例经皮冠状动脉介入术后1年造影随访分析

Angiographic analysis of coronary artery diseases one year after percutaneous coronary intervention : report of 429 patients

摘要:

目的 评价冠状动脉多支血管病变（MVD）通过经皮冠状动脉介入（PCI）进行血运重建的长期疗效。方法 2010年3月至2011年5月在第三军医大学附属西南医院成功接受PCI治疗的429例患者，术后约1年进行血管造影随访，并对其心绞痛复发率、造影复查再狭窄率和主要不良心脏事件（MACE）发生率进行回顾分析。结果 429例PCI患者完全性血运重建病例比率为95.8%，住院期间无心源性死亡病例，其心绞痛复发率、造影复查再狭窄率分别为10.1%、4.4%，MACE主要是1年内再次行血运重建的患者，发生率为3.5%。患者血运重建后心功能、每周心绞痛发作频次均有明显改善，显著提高了患者的生活质量及生存率。结论 PCI进行血运重建是治疗冠心病特别是MVD的有效方法，合理的PCI方案及药物洗脱支架的应用是改善患者远期预后的关键。

Abstract:

Objective To evaluate the long-term therapeutic effect of percutaneous coronary intervention (PCI) on revascularization in patients with coronary artery multi-vessel diseases (MVD). Methods A total of 429 patients who underwent successful PCI in our department from March 2010 to May 2011 were subjected in this study. Angiography was carried out on these patients one year after PCI. The rates of angina recurrence, angiographic restenosis and major adverse cardiac events (MACE) were retrospectively analyzed during the follow-up of 12.9 months (ranging from 8 to 15 months). Results Among the 429 patients, complete revascularization was seen in 95.8% of patients (411/429). There was no death in hospital and follow-up time. The rates of angina recurrence and angiographic restenosis were 10.1% and 4.4% respectively. The rate of MACE accounted for 3.5%, which was mostly found in those receiving revascularization within 1 year after PCI. Revascularization improved their heart function and frequency of angina obviously, and promoted their quality of life and survival rate. Conclusion The PCI revascularization is an effective approach in patients with coronary artery disease, especially MVD. PCI strategy and rational implantation of drug eluting stent (DES) play key roles in long-term prognosis in the patients.