目的 探讨亚急性、慢性闭塞性冠状动脉病变经皮腔内冠状动脉成型术(PTCA)及支架置入术的临床疗效。方法对115例行PTCA术的冠状动脉闭塞病例(115支闭塞血管)的临床资料进行回顾性分析。根据冠状动脉闭塞的时间将病人分为二组:43例为亚急性闭塞组(1-30d),72例为慢性闭塞组(1-108月),均按常规行PTCA及支架置入术操作。结果两组病人的性别、年龄、冠心病的易患因素、病变支数、闭塞血管部位等无明显差异。亚急性闭塞组心肌梗死发生率为65％,明显高于慢性闭塞组9％;慢性闭塞组不稳定型心绞痛发生率为91％,明显高于亚急性闭塞组35％。亚急性闭塞组导丝通过率97％,球囊扩张率97％,支架置入率为95％。慢性闭塞组导丝通过率90％,球囊扩张率87％,支架置入率为85％。结论本研究表明闭塞血管的介入治疗是安全有效的,亚急性闭塞组成功率高于慢性闭塞组。急性并发症发生率很低。手术的成功与闭塞的时间、造影的特点、器械的选择以及术者的技术有关。 Objective To investigate the clinical effects of percutaneous transluminal coronary angioplasty (PTCA) and stent implantation in patients with subacute and chronic obstructive coronary lesions. Methods The clinical data of 115 patients with coronary artery occlusion undergoing PTCA (115 occlusive vessels) were retrospectively analyzed. According to the time of coronary occlusion, the patients were divided into two groups: 43 cases were subacute occlusion group (1-30 days) and 72 cases were chronic occlusion group (1-10 months). All cases were performed PTCA and stenting . Results There were no significant differences in gender, age, predisposition to coronary heart disease, lesion count, and occlusion of the two groups of patients. The incidence of MI in subacute occlusion group was 65%, significantly higher than that in chronic occlusion group (9%). The incidence of unstable angina in chronic occlusion group was 91%, which was significantly higher than that in subacute occlusion group (35%). Subacute occlusion group guide wire through rate of 97%, balloon expansion rate of 97%, stent placement rate of 95%. Chronic occlusion group guide wire through rate of 90%, balloon expansion rate of 87%, stent placement rate of 85%. Conclusion This study shows that interventional occlusion of the occluded vessels is safe and effective. The subacute occlusion group has higher success rate than the chronic occlusion group. The incidence of acute complications is low. The success of surgery and occlusion of the time, the characteristics of angiography, the choice of equipment and the skill of the surgeon.