摘要
目的 评估年轻冠心病患者 (<4 5岁 )冠状动脉 (冠脉 )内支架术后的长期疗效。方法 1996年 7月至 2 0 0 2年 3月 ,6 5例年龄 <4 5岁的患者接受冠脉内支架术治疗 (年轻组 ) ,随机选取 6 5例同期年龄 >4 5岁行冠脉内支架术患者作为对照组。比较两组一般情况、冠脉病变、介入治疗及随访情况。结果 年轻组患者心肌梗死 (心梗 )较对照组多见 (分别为 6 8%和 35 % ,P <0 .0 5 ) ;单支冠脉病变患者明显较多 (83%和 5 7% ,P =0 .0 0 1) ,单支病变中以左前降支多见 (4 6 5 7和 2 4 37,P =0 .0 2 ) ;介入治疗后达到完全血运重建者多 (95 %和 78% ,P =0 .0 0 4 )。平均随访 (6 7± 9)个月 ,年轻组患者再发胸痛及再次住院发生率明显高于对照组 (分别为 35 %和 17% ,P =0 .0 2 ,2 8%和 14 % ,P =0 .0 5 ) ,新生病变发生率明显高于对照组 (4 4 %和 11% ,P =0 .0 2 )。年轻组随访主要终点及次要终点的发生率均明显高于对照组 (分别为 2 3%和 9% ,P =0 .0 3;35 %和 17% ,P =0 .0 2 )。结论 年轻患者冠脉支架术完全血运重建率高 ,术后心脏事件的发生主要由新生冠脉病变引起。冠脉内支架植入术可作为年轻冠心病患者的首选治疗方式。
Objective To evaluate the long-term effect of coronary stenting in young coronary artery diseased patients (<45 years old).Methods From July 1996 to March 2002, sixty-five patients younger than 45 years-old underwent coronary stent implantation were included as the younger group. Another 65 contemporary older patients (>45) undergoing coronary stenting were chosen randomly as the control group. Comparison the general characteristics, coronary angiographies, interventional and follow-up informations between the two groups was undertaken. Results Comparing with the control group, the young group patients presented much more myocardial infarctions (68% vs 35%, P <0.05) and single-vessel disease (83% vs 57%, P =0.001). Complete revascularization was achieved in 95% patients in the young group (95% vs control 78%, P =0.004). With a mean 67±9 months follow-up, recurrent angina and readmission rate were higher in the young group, as well as the incidence of MACE. Repeat CAG revealed much more de novo lesions in the young group (44% vs 11%, P =0.02) and higher rate of re-stenting.Conclusions Due to the high rate of complete circulatory reconstruction in young patients, the postprocedural events are probably caused by new coronary arterial lesions, therefore coronary stenting should be regarded as the primary choice of treatment.
出处
《介入放射学杂志》
CSCD
2004年第6期493-495,共3页
Journal of Interventional Radiology
