摘要
目的：评估肌钙蛋白I（c Tn I）转归前后经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）与冠状动脉旁路移植术（coronary artery bypass grafting,CABG）治疗急性非ST段抬高心肌梗死（non-ST segment elevated myocardial infarction,NSTEMI）的有效性及安全性。方法：入选2008年1月1日至2013年4月30日就诊于我院并接受PCI或CABG治疗的NSTEMI患者329例,分为c Tn I转归前PCI干预组（A组）、c Tn I转归前CABG干预组（B组）、c Tn I转归后PCI干预组（C组）和c Tn I转归后CABG干预组（D组）。计算和比较各组的临床终点事件的发生率,再灌注策略对临床终点事件的优势比（OR）。结果：四组患者的完全血运重建率比较差异有统计学意义（P〈0.05）,B、C、D组显著高于A组（P〈0.05）,而B、C、D组之间比较无统计学差异（P〉0.05）。术后24个月,再次血运重建率：A组12.9%和B组3.4%（OR=3.82,95%CI：1.03～16.60）,A组12.9%和C组5.1%（OR=2.55,95%CI：1.29～6.61）;MACCE事件发生率：A组14.1%和C组5.9%（OR=2.38,95%CI：1.15～5.79）,以上结果比较差异均有统计学意义（P〈0.05）。结论：c Tn I转归后行PCI治疗NSTEMI伴多支病变患者较c Tn I转归前PCI更有利于减少MACCE事件和再次血运重建的发生,c Tn I转归前行CABG术在降低血运重建发生率方面较优于PCI治疗。
Objective： To evaluate the clinical efficacy and safety of PCI before and after cardiac troponin（c Tn I） returned to normal and CABG in the treatment of non-ST segment elevated myocardial infarction（NSTEMI）. Methods： From Jan 1 2008 to Apr 302013, 329 patients receiving PCI or CABG in our hospital were screened and enrolled into this study. The patients were divided into four groups： PCI before c Tn I returned to normal（A group）, CABG before c Tn I returned to normal（B group）, PCI after c Tn I returned to normal（C group） and CABG after c Tn I returned to normal（D group）. The incidences of clinical events of four groups were compared and the odds ratio（OR）of efficacy and safety endpoints were calculated. Results： There are difference in completeness of reveascularisation among the four groups（P〈0.05）, The percentages of complete reveascularisation of group B, C and D were significantly higher than that of group A（P〈0.05）, however, no significant difference was found among the three groups（P〉0.05）. At 24 th month after operation, the percentages of complete reveascularisation were 12.9% in group A and 3.4% in group B（OR=3.82, 95% CI： 1.03～16.60）, 12.9% in group A and 5.1% in group C（OR=2.55, 95% CI： 1.29～6.61）, the incidence of MACCE were 14.1% in group A and 5.9% in group C（OR=2.38, 95% CI： 1.15～5.79）（P〈0.05）. Conclusion： For NSTEMI patients with multivessel disease, PCI after c Tn I return to normal could be beneficial to reduce the revascularization rates and incidence of MACCE compared with PCI before c Tn I return to normal, the CABG treatment is was superior to PCI before c Tn I return to normal in reducing the rates of revascularization.
出处
《现代生物医学进展》
CAS
2015年第28期5535-5538,5585,共5页
Progress in Modern Biomedicine
基金
青岛市公共领域科技支撑计划项目(11-2-3-2-(11)-nsh)
