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目的观察无保护左主干病变,应用药物洗脱支架介入治疗后冠状动脉造影随访结果,并分析其影响因素。方法选择无保护左主干病变患者150例,其中48例在平均(10.0±7.5)个月进行了冠状动脉造影复查,根据冠状动脉造影显示有无狭窄分为:再狭窄组12例和无再狭窄组36例。结果与无再狭窄组比较,再狭窄组患者随访时最小管腔直径明显减小[(2.7±1.0)mm vs (3.5±0.4)mm,P=0.0001]、直径狭窄率明显升高[(31.4±26.4)% vs (8.3±5.3)%,P=0.0000]、晚期管腔丢失明显升高[(0.8±0.7)mm vs (0.2±0.3)mm,P=0.0000];双支架置入术的再狭窄率明显高于单支架置入术[(75.0% vs 13.9%),P=0.0011]。结论左主干远端分叉病变双支架置入术的疗效较差,冠状动脉旁路移植术应作为首选。
Objective To observe the unprotected left main trunk lesions and the follow-up results of coronary angiography after interventional therapy with drug-eluting stents and analyze the influencing factors. Methods A total of 150 patients with unprotected left main disease were enrolled in this study. Forty-eight of them were examined by coronary angiography on average (10.0 ± 7.5) months. According to coronary angiography, there were 12 cases with restenosis and no restenosis Group of 36 cases. Results Compared with those without restenosis, the diameter of the smallest lumen in the restenosis group was significantly decreased at the follow-up [(2.7 ± 1.0) mm vs (3.5 ± 0.4) mm, P = 0.0001], and the stenosis rate was significantly increased [(31.4 (0.8 ± 0.7) mm vs (0.2 ± 0.3) mm, respectively, P = 0.0000]. The double stenting The restenosis rate was significantly higher than the single stenting [(75.0% vs 13.9%), P = 0.0011]. Conclusions The left main distal bifurcation double stenting has poor curative effect. Coronary artery bypass grafting should be the first choice.