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目的:探讨冠状动脉旁路移植术术后再次发作心肌缺血事件的原因。方法:回顾性分析545例行冠状动脉旁路移植术术后复发心绞痛接受冠状动脉造影检查患者的临床资料。结果:545例冠状动脉旁路移植术术后复查冠状动脉造影的患者,糖尿病患者为156例(28.6%),较非糖尿病患者搭桥术后心绞痛复发时间短(P<0.05)。266例患者药物治疗(48.8%)。247例接受再次介入治疗(45.3%),32例行二次冠状动脉旁路移植术。冠状动脉旁路移植术术后1个月内复发症状者冠状动脉造影显示左乳内动脉闭塞37.5%,1～12个月大隐静脉桥狭窄16.3%,闭塞15.2%,左乳内动脉狭窄15.3%。>1年后症状复发桥血管闭塞以静脉桥为主。结论:冠状动脉粥样硬化的危险因素及搭桥血管的类型影响再次冠状动脉治疗的必要性和倾向性。
Objective: To investigate the causes of recurrent myocardial ischemia after coronary artery bypass grafting. Methods: The clinical data of 545 patients undergoing coronary angiography after coronary artery bypass grafting were retrospectively analyzed. Results: Of the 545 coronary artery bypass grafting patients who underwent coronary angiography, there were 156 patients (28.6%) with diabetes and a shorter recurrence of angina (P <0.05) than non-diabetic patients. 266 patients medication (48.8%). 247 patients underwent interventional intervention (45.3%) and 32 underwent coronary artery bypass grafting. Coronary artery angiography within 1 month after coronary artery bypass grafting demonstrated coronary artery occlusion in 37.5% of the left internal mammary artery, stenosis of the great saphenous vein vein in 1 to 12 months, occlusion of 15.2%, arterial stenosis in the left internal mammary artery of 15.3 %. > 1 year after the resurfacing bridge vascular occlusion to the main venous bridge. Conclusion: The risk factors of coronary atherosclerosis and the types of bypass grafts influence the necessity and tendency of coronary artery re-treatment.