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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2009年第1期

页码:

69-72

栏目:

临床研究

出版日期:

2009-02-28

文章信息/Info

Title:

Efficacy and safety of coronary intervention treatment in long duration occlusion patients with chronic total occlusions

作者:

李娜¹; 韩雅玲²; 张剑²; 荆全民²; 王守力²

1.第四军医大学西京医院心内科，陕西 西安 710032； 2.沈阳军区总医院心内科 全军心血管病研究所，辽宁 沈阳 110016

Author(s):

LI Na¹;  HAN Ya-ling²;  ZHANG Jian²;  JING Quan-min²;  WANG Sou-li²

1.Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi, China; 2.Department of Cardiology, Shenyang General Hospital, Cardiovascular Research Institute of PLA, Shenyang 110016, Liaoning, China

关键词:

冠状动脉疾病; 慢性完全闭塞; 冠状动脉血管成形术; 经腔; 经皮

Keywords:

coronary disease;  chronic total occlusion;  coronary angioplasty;  transluminal;  percutaneous

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的 回顾性分析长闭塞时间冠状动脉慢性完全闭塞（CTO）病变介入治疗的疗效及安全性。方法 2006年1月~2007年6月入院行冠脉造影检查发现有CTO病变并行经皮冠脉介入（PCI）治疗的358例患者。分组标准：病变闭塞时间≤12个月组（135例），病变闭塞时间>12个月组（223例）。对两组患者临床资料、PCI结果以及围术期并发症和随访期间主要不良心脏事件（MACE）进行回顾性分析。结果 与病变闭塞时间≤12个月比较，闭塞时间>12个月组的CTO患者老年患者（≥60岁）、糖尿病患者比例高（P<0.01），女性患者、高血压患者比例也高于闭塞时间≤12个月组（P<0.05）。闭塞时间>12个月组的CTO病变绝对性闭塞比例高(P<0.01)，刀切状病变、长度≥15 mm或并发桥状侧支循环形成的CTO比例也均高于闭塞时间≤12个月组（均P<0.05）。两组病变和病例成功率无统计学差异（91% vs 95%, 93% vs 97%）。两组术中无死亡病例，术后住院期间无主要不良心脏事件（MACE）发生，无患者进行急诊冠状动脉旁路移植术（CABG）。术后MACE发生率1年随访结果无统计学差异。结论 PCI治疗闭塞时间较长的CTO病变也可获得较高的成功率和较好的近期临床效果。

Abstract:

AIM To perform a retrospective analysis of the efficacy and safety of percutaneous coronary intervention(PCI) treatment in long duration occlusions patients with chronic total occlusions(CTO). METHODS Patients with CTO confirmed by coronary angiography and treated by PCI between January 2006 and June 2007 were enrolled in our study. The clinical data, outcomes of PCI, perioperative complications and the incidence of major adverse cardiac events(MACE) during follow-up were retrospectively analyzed between Group One (the occlusion time was equal to or less than 12 months, n=135) and Group Two(the occlusion time was longer than 12 months, n=223). RESULTS The proportions of senile patients and female patients and the proportions of patients with hypertension and diabetes mellitus in Group Two were higher than those in Group One. The ratios of CTO characterized with absolute occlusion, stump missing, ≥15 mm in length and bridging collaterals in Group Two were higher than those in group One. No statistical difference was found in the success rate of lesions and patients between the two groups(91% vs 95%, 93% vs 97%). No death occurred during operation, no major adverse cardiac events(MACE) occurred after operation in hospital and no patients undertook emergency coronary artery bypass graft(CABG) in the two groups. No statistical difference was found in the MACE occurrence of one year follow up. CONCLUSION A relatively high success rate of PCI and good short-term clinical outcomes can be achieved in patients with long duration of occlusion.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2008-1-3.作者简介：李娜，硕士生Email:angellina767@sina.com

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更新日期/Last Update: 2009-04-02