合并肾小球滤过率下降的冠状动脉多支病变患者不同血运重建策略的预后分析

被引：2

作者：

高晓东 ^{[1
,2
]}

康俊萍 ^{[1
]}

吕强 ^{[1
]}

刘新民 ^{[1
]}

胡荣 ^{[1
]}

马长生 ^{[1
]}

刘小慧 ^{[1
]}

机构：

[1] 首都医科大学附属北京安贞医院心内科二病房

[2] 北京安贞医院心内科

来源：

中国介入心脏病学杂志 | 2009年 / 17卷 / 04期

关键词：

肾小球滤过率; 冠状动脉疾病; 心肌血管重建术; 预后;

D O I：

暂无

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

1002 ; 100201 ;

摘要：

目的评价合并中重度肾小球滤过率(glomerrular filtration rate,GFR)下降的冠状动脉多支病变患者进行完全和不完全血运重建的近期与远期疗效及预后。方法DESIRE(Drug-Eluting Stent Impact on REvascularization)为单中心注册回顾性研究,入选2003年7月至2005年9月期间收入我院经冠状动脉造影诊断为冠心病多支病变并接受经皮冠状动脉介入治疗(PCI)的患者和冠状动脉旁路移植术(CABG)治疗的多支病变患者,选择GFR≤60 mL/(min.1.73 m2)者共584例。根据是否完全血运重建分为两组,记录两组患者的临床资料并进行随访,分析各组的临床特点、住院期间及随访中的死亡率和主要心脑血管事件(MACCE)的发生情况,平均随访时间为533 d,观察完全与不完全血运重建患者的近期与远期疗效。以Cox回归分析影响此类患者预后(病死率)的相关因素。结果冠心病多支病变患者血运重建完全者与血运重建不完全者的近期死亡、新发急性心肌梗死、卒中的发生率差异无统计学意义(P>0.05);远期死亡、MACCE的发生率、总心性死亡率差异也没有统计学意义(P>0.05)。Cox多因素回归分析表明患者的预后与完全血运重建无关(HR1.297,95%CI0.478～3.520,P>0.05)。结论对于中重度肾小球滤过率下降的多支病变患者完全血运重建与不完全血运重建临床效果相似。

引用

页码：195 / 198

页数：4

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