摘要
目的探讨经皮冠状动脉介入（PCI）治疗冠状动脉左主干（LMCA）病变的长期疗效。方法回顾性分析2009年7月至2014年6月在上海长海医院行冠状动脉造影并支架植入术的128例LMCA病变患者的临床资料,统计LMCA病变类型、支架植入情况及主要心脏不良事件（MACE）。结果 128例患者LMCA病变狭窄程度为50.00%-100.00%,平均（72.20±10.63）%;LMCA病变位于开口部24例（18.75%）,体部14例（10.94%）,累及远端分叉部90例（70.31%）。128例患者均成功植入支架,支架植入成功率为100.00%,单支架术50例（39.07%）,双支架术78例（60.93%）,共植入药物洗脱支架206枚,支架平均直径为（3.69±0.40）mm,平均长度为（21.99±6.83）mm。128例患者均获得随访,平均随访（50.97±17.15）个月,术后发生MACE 21例（16.40%）,包括非致死性心肌梗死5例（3.90%）、靶血管再次血运重建11例（8.59%）和全因死亡5例（3.90%）,生存率为96.09%（123/128）。结论 LMCA病变患者行冠状动脉内支架植入术治疗安全、有效。应根据LMCA病变的部位、分型及复杂程度,评估PCI获益和风险,科学地制定治疗策略。
Objective To investigate the long-term effect of percutaneous coronary intervention（ PCI） in the treatment of left main coronary artery（ LMCA） lesion. Methods The clinical data of 128 patients with LMCA lesion who underwent coronary angiography and stent implantation in Changhai Hospital of Shanghai City from July 2009 to June 2014 were analyzed retrospectively. The type of LMCA lesion,stent implantation and major adverse cardiac event（ MACE） were observed. Results The average stenosis of LMCA in 128 patients was（ 72. 20 ± 10. 63） %（ range 50. 00%- 100. 00%）. The LMCA ostial,shaft and bifurcation lesions were 24（ 18. 75%）,14（ 10. 94%） and 90（ 70. 31%） cases respectively. A total of 128 patients were successfully implanted stents,the success rate of stent implantation was 100. 00%. Among the patients,single stent implantation was performed in 50 cases（ 39. 07%）,and double stent implantation was performed in 78 cases（ 60. 93%）. A total of 206drug-eluting stent were implanted. The average diameter of the stent was（ 3. 69 ± 0. 40） mm,and the average length was（ 21. 99 ± 6. 83） mm. A total of 128 patients were followed up for（ 50. 97 ± 17. 15） months. MACE occurred in 21 cases（ 16. 40%） after operation,including 5 cases（ 3. 90%） of non-fatal myocardial infarction,11 cases（ 8. 59%） of target vessel revascularization,5 cases（ 3. 90%） of all-cause death. The survival rate was 96. 09%（ 123 /128）. Conclusion Coronary artery stent implantation in LMCA lesions is safe and effective. Operators should scientifically formulate treatment strategies by evaluating the benefit and risk of LMCA on the basis of lesion position,type and complexity.
出处
《新乡医学院学报》
CAS
2016年第6期473-475,共3页
Journal of Xinxiang Medical University
基金
国家自然科学基金面上项目(编号:81370266)
上海市科学技术委员会基金资助项目(编号:134119a0301)
