摘要
目的:比较既往有冠状动脉旁路移植术(CABG)和既往无CABG对原位血管慢性完全闭塞(CTO)病变行经皮冠状动脉介入治疗(PCI)的影响。方法:选择2016年10月—2021年12月就诊于辽宁省人民医院接受CTO-PCI术且既往有CABG的患者82例作为病例组,采用1︰2匹配病例-对照研究方法,选择相同术者同期手术既往无CABG的CTO-PCI患者164例作为对照组,匹配的条件是性别相同,年龄±3岁。比较两组患者的基线资料、手术成功率和住院并发症等。结果:既往有CABG组患者高血压病(73.2%∶57.9%,P=0.020)、高脂血症(40.2%∶27.4%,P=0.042)、糖尿病(48.8%∶35.4%,P=0.043)和卒中史(11.0%∶3.7%,P=0.024)明显高于既往无CABG组。既往有CABG组患者钙化(61.0%∶37.8%,P=0.001)、闭塞节段成角≥45°(63.4%∶37.8%,P<0.001)、闭塞长度>20 mm(56.1%∶39.0%,P=0.011)明显高于对照组,且J-CTO评分[(2.5±0.9)分∶(1.8±0.9)分,P<0.001]及≥3分的比例更高(48.8%∶30.5%,P=0.005)。既往有CABG组患者应用逆向技术(46.3%∶26.2%,P=0.002)比例更高,但技术成功率(89.0%∶95.7%,P=0.044)、手术成功率(80.5%∶90.9%,P=0.021)均明显低于既往无CABG组,而围术期心肌损伤(6.1%∶0.6%,P=0.028)显著高于既往无CABG组。两组在其他并发症方面比较,差异均无统计学意义。结论:与既往无CABG组相比,既往有CABG组的患者病变更复杂,更多地使用逆向技术,技术及手术成功率均更低,但两组的并发症相似。
Objective: To compare the effects of previous coronary artery bypass graft(CABG) and previous non-CABG on percutaneous coronary intervention(PCI) in patients with chronic total occlusion(CTO). Methods: A total of 82 patients with CABG underwent CTO-PCI were selected as the case group in Liaoning Provincial People’s Hospital from October 2016 to December 2021. A 1: 2 matched case-control study was conducted. The 164 patients with CTO-PCI who underwent the same operation in the same period were selected as the control group. The matching conditions were the same sex and age ±3 years old. The baseline data, operation success rate and hospitalization complications were compared. Results: Compared with the patients without prior CABG, the patients with prior CABG had more hypertension(73.2% vs 57.9%, P=0.020) 、hyperlipidemia(40.2% vs 27.4%, P=0.042) 、diabetes(48.8% vs 35.4%, P=0.043) and stroke history(11.0% vs 3.7%, P=0.024). The patients with previous CABG had more complicated CTO lesions: calcification(61.0% vs 37.8%, P=0.001), occlusive segment angulation ≥ 45 °(63.4% vs 37.8%, P<0.001), occlusion length>20 mm(56.1% vs 39.0%, P=0.011), and higher J-CTO score(2.5±0.9 vs 1.8±0.9 scores, P<0.001) and higher proportion of ≥ 3 scores(48.8% vs 30.5%, P=0.005). The use of reverse technology in patients with prior CABG(46.3% vs 26.2%, P=0.002) was significantly higher than that in the control group. However, the technical success rate(89.0% vs 95.7%, P=0.044) and surgical success rate(80.5% vs 90.9%, P=0.021) in the previous CABG group were significantly lower than those in the previous group without CABG, while the perioperative myocardial injury(6.1% vs 0.6%, P=0.028) was significantly higher than that in the previous group without CABG. There was no significant difference in other complications between the two groups. Conclusion: Compared with the patients without prior CABG, the patients with prior CABG had more complex lesions, more use of retrograde techniques, and lower success rates of technique and operation, but the complications of the two groups were similar.
作者
戴欣彤
孔天钟
侯爱洁
栾波
张晓娇
王永
DAI Xintong;KONG Tianzhong;HOU Aijie;LUAN Bo;ZHANG Xiaojiao;WANG Yong(Department of Cardiology,People’s Hospital of China Medical University,Liaoning Provincial People’s Hospital,Shenyang,110016,China)
出处
《临床心血管病杂志》
CAS
北大核心
2022年第5期356-360,共5页
Journal of Clinical Cardiology
基金
辽宁省科学技术计划项目(No:2020JH1/10300002)。
作者简介
通信作者:侯爱洁,E-mail:1758624242@qq.com。
