摘要
目的观察老年无保护左主干病变患者介入术中联合运用血管内超声(IVUS)检查的疗效及预后。方法选取经冠脉介入治疗的老年无保护左主干病变114例患者,将介入治疗联合运用IVUS检查的患者38例纳入观察组,将介入治疗中未运用IVUS检查的患者76例纳入对照组,并对2组患者长期跟踪随访。结果观察组测得的最小管腔直径(MLD)、最小管腔面积(MLA)显著高于对照组,而管腔面积狭窄率(AS)则低于对照组,但观察组置入的支架大于对照组,差异均有统计学意义(P<0.05)。术后对入选患者进行12个月随访调查,期间有完成造影随访47例(41.2%),其中,观察组12例(31.6%),对照组35例(46.1%)。2组患者心源性死亡、非致死性心肌梗死的发生率比较差异均无统计学意义(P>0.05);观察组再狭窄、再发心绞痛、靶血管血运重建、总MACE事件的发生率均低于对照组,差异均有统计学意义(P<0.05)。结论老年人冠脉左主干病变介入治疗联合运用血管内超声能显著减少患者不良事件发生率,对临床手术具有一定指导意义。
Objective To investigate the efficacy and prognosis of interventional therapy combined with intravascular ultrasound( IVUS) in the treatment of unprotected left main coronary artery disease in elderly patients. Methods Selected percutaneous coronary intervention in elderly patients with unprotected left main coronary artery disease 114 cases,interventional therapy combined with IVUS examination of 38 cases of patients were included in the observation group,76 patients who did not use IVUS in interventional therapy were included in the control group,2 groups of patients were followed up for a long time.Results The minimal lumen diameter( MLD),minimal lumen area( MLA) of observation group were significantly higher than that of control group,and lumen area stenosis rate( atherosclerosis) was lower than that of control group,but the stent implantation of observation group was more than control group,the differences were statistically significant( P < 0. 05). After operation the patients were followed up for 12 months. The patients were followed up for 47 cases( 41. 2%). Among them,12 cases in the observation group( 31. 6%) and 35 cases in the control group( 46. 1%). 2 groups of patients suffering from sudden cardiac death,the difference in the non fatal myocardial infarction incidence rate had no statistical significance( P > 0. 05). In the observation group,the total mace incidence of estenosis,recurrent angina pectoris,target vessel blood supply reconstruction were lower than control group,the differences were statistically learning significance( P < 0. 05). Conclusion Percutaneous coronary intervention with intravascular ultrasound can significantly reduce the incidence of adverse events in patients with elderly unprotected left main coronary artery disease,and have certain guiding significance for clinical surgery.
出处
《临床合理用药杂志》
2016年第4期19-20,共2页
Chinese Journal of Clinical Rational Drug Use
关键词
血管内超声
老年人
无保护左主干病变
介入治疗
Intravascular ultrasound
Elderly
Unprotected left main
Percutaneous coronary intervention
