摘要
目的:比较老年多支冠状动脉病变患者雷帕霉素洗脱支架植入(DES)与冠状动脉搭桥术(CABG)的远期疗效。方法:随机入选我院年龄大于75岁,并成功行择期血运重建的,有多支冠状动脉病变的住院患者322例,分为CABG组(160例),DES组(162例)。随访5年的主要不良心脑血管事件(MACE)。采用Kaplan-Meier方法估计无事件生存率。采用Logistic多元回归方法分析治疗对终点事件的影响。结果:322例随访率100%,与DES组比较,CABG组5年MACE发生率明显减低(18.52%比3.75%,P<0.05),再次血运重建率明显减低(12.3%比0.63%,P<0.01);两组间5年生存率无明显差异(98.8%比98.1%,P>0.05)。结论:高龄老年多支冠脉病变患者CABG与雷帕霉素洗脱支架植入比较,二者生存率无显著差异;但CABG组的远期心脑血管事件发生率、血运重建率显著低于雷帕霉素洗脱支架植入组。
Objective： To compare long-term effect between rapamycin-eluting stent （DES） implantation anal coronary artery bypass graft （CABG） in aged patients with multiple vessel coronary disease （MVD）. Methods： A total of 322 MVD inpatients with age〉75 years old undergoing successful selective revascularization were randomly enrolled, and they were divided into DES group （n = 162） and CABG group （n = 160）. All patients were followed up for five years for major adverse cardiac and cerebrovascular events （MACE）. Kaplan-Meier method was used to evaluate no- event survival rate. Logistic multiple regression method was used to analyze influence of therapy on endpoint events. Results： Follow-up rate of 322 cases was 100%. In five-year follow-up, compared with DES group, incidence rate of MACE （18.52% vs. 3.75%, P〈0.05） and revascularization rate （12.3% vs. 0.63%, P〈0.01） significantly decreased in CABG group. There was no significant difference in five-year survival rate between two groups （98. 8% vs, 98.1%, P〉0.05）. Conclusion： Compared with rapamycin-eluting stent implantation, there is no significant difference in long-term survival rate in CABG group, but MACE incidence rate and revascularization rate of CABG group, are significantly decreased in aged patients with multiple vessel coronary disease.
出处
《心血管康复医学杂志》
CAS
2012年第5期516-519,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
