摘要
Objective To examine long term efficacy of percutaneous transluminal coronary angioplasty (PTCA),coronary stenting and to assess the factors affecting its efficacy Methods A total of 790 patients who underwent successful PTCA and PTCA+stent in this hospital were followed by direct interview or letter The rate of follow up was 84 2% and the period of follow up was 0 9-12 7 (3 5±2 4) years Results During follow up, 4 (0 5%) patients died, 22 (2 8%) had nonfatal acute myocardial infarction, 10 (1 3%) had coronary artery bypass surgery, and 98 (12 4%) had repeat PTCA The rate of recurrent angina pectoris was 31 1% The cardiac event free survival rate calculated by the Kaplan Meier method was 88 2% at 1 year and 80 6% at 12 7 years Cox regression analysis showed that there was a positive correlation between AMI history, stent implantation and the risk of cardiac events, and there was a negative correlation between the number of diseased arteries and the risk of cardiac events Compared to the PTCA group, patients with PTCA+stent had significantly lower rates of total cardiac events Conclusion The long term efficacy of PTCA, especially PTCA + stent in Chinese patients was very satisfactory, suggesting that PTCA+stent therapy should be the major treatment for revascularization in patients with coronary heart disease
目的 探讨经皮冠状动脉腔内成形术 (PTCA)和PTCA +支架治疗对我国冠心病患者的远期疗效。方法 对自 1986年 12月至 1998年 6月期间在我院接受PTCA和PTCA +支架治疗的 938例中的 790例患者进行了随访 ,随访率 84 2 %。随访方式包括门诊随访和信访。随访时间为 0 9- 12 7年 (平均 3 5± 2 4年 )。结果 随访期中死亡 4例 (0 5 1% ) ,非致命性急性心肌梗塞 2 2例 (2 8% ) ,重复PTCA 98例 (12 4 % ) ,行冠状动脉旁路移植术 10例 (1 3% )。以Kaplan Meier法计算术后 12年的生存率为 99 5 % ,无心脏事件生存率 1年为88 2 % ,12年为 80 6 %。Cox回归分析显示 ,陈旧性心肌梗死病史和是否放置支架与心脏事件呈负相关 ,而病变支数与心脏事件正相关。与单纯PTCA组比较 ,PTCA +支架组急性心肌梗死发生率和再次PTCA率均显著低于前者。结论 PTCA ,特别是PTCA +支架治疗对我国冠心病患者有良好的疗效 ,可作为血管重建治疗的首选方法。
