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目的 :探讨完全性血运重建与非完全性血运重建对多支冠状动脉病变患者预后的影响。方法 :回顾性分析接受介入治疗的 10 2例多支冠状动脉病变患者的临床资料及随访情况 ,根据主要的冠状动脉及其重要分支是否完全再血管化分为完全血运重建组 (4 6例 )和非完全血运重建组 (5 6例 ) ,比较两组患者围手术期死亡率、随访期间心血管总死亡率、急性心脏事件发生率和因心血管原因再次入院率。结果 :两组患者的性别构成、原发性高血压、高脂血症、吸烟及其心肌梗死病史例数均无显著性差异 ,平均年龄非完全血运重建组略高于完全血运重建组〔(6 8± 9)∶(6 5± 6 )岁 ,P <0 .0 5〕 ,非完全血运重建组糖尿病患病率较高 (80 .4 % )且左室射血分数较低〔(4 5± 9) %〕 ,与完全血运重建组〔6 9.6 %、(5 2± 11) %〕比较 ,P <0 .0 5。完全血运重建组的随访期间总死亡 (2例 )、急性心脏事件 (12例次 )和心血管再次入院次数 (18例次 )均显著低于非完全血运重建组 (分别为 12、38、5 2例次 )。另在非完全血运重建组中有 6例患者已经达到功能上完全血运重建 ,随访期间无死亡及急性心脏事件发生。结论 :与非完全血运重建相比 ,完全血运重建能显著改善冠心病多支病变患者的预后 ,对于冠心病多支病变患者 ,应尽可能达到完全血运?
Objective: To investigate the effect of complete revascularization and incomplete revascularization on the prognosis of patients with multivessel coronary artery disease. Methods: The clinical data and follow-up of 102 patients with multivessel coronary artery disease who underwent interventional therapy were retrospectively analyzed. According to whether the main coronary artery and its important branches were completely revascularized, they were divided into complete revascularization group (46 cases ) And non-complete revascularization (56 cases). The perioperative mortality rate, total cardiovascular death rate, acute cardiac event rate and rehospitalization rate due to cardiovascular disease during the follow-up period were compared between the two groups. Results: There was no significant difference in gender composition, essential hypertension, hyperlipidemia, smoking and the history of myocardial infarction between the two groups. The average age of patients with incomplete revascularization was slightly higher than that of patients with complete revascularization 〔(6 8 ± 9): (65 ± 6) years, P <0.05). The prevalence of diabetes was significantly higher in non-complete revascularization group (80.4%) and the left ventricular ejection fraction was lower 〔(45 ± 9)%〕, P <0.05 compared with complete revascularization group (9.6%, (52 ± 11)%〕. The total number of deaths (2), acute cardiac events (12) and cardiovascular re-admission (18) were significantly lower in the complete revascularization group than in the non-complete revascularization group (12, 38 , 52 cases). In addition, six patients in the non-complete revascularization group had achieved full-fledged revascularisation with no death or acute cardiac events during follow-up. CONCLUSION: Compared with incomplete revascularization, complete revascularization can significantly improve the prognosis of patients with multi-vessel disease of coronary heart disease. For patients with multi-vessel disease of coronary heart disease, complete blood supply should be achieved as much as possible.