摘要
目的：评价 Ｐ Ｔ Ｃ Ａ 结合支架治疗冠心病左室功能不全的安全性和近、远期疗效． 方法：回顾性分析１９９０１／１９９７１２ 本院所有行 Ｐ Ｔ Ｃ Ａ 治疗； Ｌ Ｖ Ｅ Ｆ≤４０％ 患者临床资料．结果：７４ 例患者中８６％ 有心梗史，５８％ 有心绞痛，６１％ 合并心衰，７４％ 为多支病变， Ｌ Ｖ Ｅ Ｆ 为（２９．０±８．６）％ ，（６～４０）％ ．４６％ 患者植入支架 ５０ 个． 病变成功率 ８９．５％ ，病例成功率８９．２％ ，严重并发症 ２．７％ ，其中病死率 １．４％ ，急性心梗２７％ ，急诊 Ｃ Ａ Ｂ Ｇ ０． ６６ 例成功病例随诊（２９±３３）ｍ ｏ，（６～９６） ｍ ｏ，５８ 例（８７．９％ ）随诊期间生存，４４ 例（６８．６％ ）无心脏事件（死亡、急性心梗、 Ｐ Ｔ Ｃ Ａ， Ｃ Ａ Ｂ Ｇ、症状复发）存活． ４０ 例心衰患者，２９ 例（７２．５％ ） Ｎ Ｙ Ｈ Ａ 分级减少≥１ 级． 支架组心脏事件发生率低于单纯 Ｐ Ｔ Ｃ Ａ 组（２３．５％ ｖｓ ４３．８％ ， Ｐ＝００８）． 结论： Ｐ Ｔ Ｃ Ａ 结合支架治疗冠心病左心功能不全成功率高，危险性低，长期生存率高．
AIM: To examine the safety and efficacy of stenting supported coronary angioplasty in patients with coronary artery disease and severe left ventricular dysfunction. METHODS:, The data of all patients with LVEF≤40% and initial angioplasty between January 1990 and December 1997 were retrospectively analyzed. RESULTS: Of the 74 patients with LVEF≤40% (mean 29.0%±8.6%), 86% had prior myocardial infarction, 58% and 61% had angina and congestive heart failure, respectively and 74% had multivessel coronary artery disease. PTCA was performed in 59(80%) patients with stent standing by. Fifty stents were placed in 34 patients (46%). Angiographic success was achieved in 89.5% of the attempted lesions. Clinical success was achieved in 89.2% of the 74 patients. Severe complication rate was 2.7% (death, 1.4%; myocardial infarction, 2.7% and emergency CABG, 0). Long term (ranging 6 96 months with a mean of 29±33 months) follow up study of 66 patients with clinical success indicated that 58 cases (87.9%) were alive, of whom 44 (68 6%) were free from cardiac events (death, myocardial infarction, revascularization procedure and clinical recurrence). Cardiac event rate was lower in stenting group than that in PTCA only group (23.5% vs 43.8%, P =0 08). CONCLUSION: In patients with severely depressed left ventricular function, stenting supported angioplasty can be performed with high success rate, low risk and improved survival rate.
出处
《第四军医大学学报》
1999年第9期800-803,共4页
Journal of the Fourth Military Medical University
关键词
冠心病
左室功能不全
PTCA血管成形术
coronary disease
angioplasty, transluminal, percutaneous coronary
stents
ventricular dysfunction, left
