摘要
目的比较急性非ST段抬高型心肌梗死(NSTEMI)在肌钙蛋白I(cTnI)转归前后采用经皮冠状动脉介入治疗(PCI)与冠状动脉旁路移植术(CABG)治疗的有效性及安全性。方法 2008年1月1日-2013年4月30日,就诊于我院并接受PCI或CABG治疗的非ST段抬高型急性心肌梗死病人329例,分为cTnI转归前PCI干预组(A组),cTnI转归前CABG干预组(B组),cTnI转归后PCI干预组(C组)和cTnI转归后CABG干预组(D组)。比较各组间完全血运重建率、主要心血管事件(MACCE)发生率。结果术后24个月,A组再次血运重建率与B、C组比较,差异有显著性(χ2=3.87、3.98,P<0.05);A组总体MACCE发生率与C组比较,差异有显著性(χ2=3.90,P<0.05)。结论 NSTEMI伴多支血管病变病人,cTnI转归后PCI干预可以较转归前PCI干预降低MACCE事件和再次血运重建率。cTnI转归前行CABG在降低再次血运重建率方面要优于PCI治疗。
Objective To compare the efficacy and safety of percutaneous coronary intervention （PCI） and coronary ar- tery bypass graft （CABG） performed before and after troponin I （cTnI） returning to normal for non-ST-elevation acute myocardial infarction （AMI）. Methods From 1 January, 2008 to 30 April, 2013, a total of 329 patients with non ST-elevation AMI were treated with PCI or CABG in our hospital. The patients were divided into four groups as group A, PCI done before cTnI levels re- turning to normal; group B, CABG done before cTnI returning to normal; group C, PCI done after cTnl returning to normal; and group D, CABG done after cTnI returning to normal. A comparison was made among each group in terms complete revascularization rate and incidence of major cardiovascular events. Results In 24 months after surgery, the revascularization rate in group A was significantly different versus groups B and C （x^2= 3.87,3.98;P 〈0.05）, the difference of incidence of major cardiovascular events between groups A and C was significant （x^2 = 3.90,P〈0.05）. Conclusion For non-ST-elevation acute myocardial infarc- tion with multivessel disease, PCI after cTnI returning to normal can reduce the incidence of major cardiovascular events and revas- cularization rate versus before cTnI returning to normal. With regard to reducing revascularization rate, coronary artery bypass graft before cTnI returning to normal is superior to PCI.
出处
《青岛大学医学院学报》
CAS
2015年第3期308-310,共3页
Acta Academiae Medicinae Qingdao Universitatis
基金
青岛市公共领域科技支撑计划项目(11-2-3-2-11-nsh)
