PCI及CABG治疗严重病变程度冠心病患者的临床效果比较

目的:比较经皮冠状动脉介入术(Percutaneous Coronary Intervention,PCI)和冠状动脉旁路移植术(Coronary Artery Bypass Grafting,CABG)治疗术前SYNTAX积分32分的重度病变冠状动脉粥样硬化心脏病(Coronary Heart Disease,CHD)患者的临床效果及安全性。方法:纳入2017年3月6日至2017年5月20日在西京医院心血管内外科成功行CABG且术前SYNTAX积分32分的重度病变CHD患者50名和成功行PCI且术前SYNTAX积分32分的重度病变CHD患者50名,分为PCI组与CABG组。比较两组患者的一般基线资料和院内死亡发生情况,术后一年电话随访患者存活情况、病死原因、再次入院、心绞痛、心肌梗死、脑卒中等发生情况,通过SF-12量表和西雅图量表评估患者的生活质量的改善情况。结果:与CABG组相比,PCI组患者心率更低、住院时间更短、住院花费更少、有PCI史的患者比例更高,差异具有统计学意义(P0.05)。术后一年,两组患者心功能改善情况和主要不良心脑血管事件(major adverse cardiac and cerebrovascular events,MACCE)发生率、SF-12量表与西雅图心绞痛量表(Seattle Angina Questionnaire, SAQ)的各个维度评分比较差异均无统计学意义(P0.05)。结论:PCI与CABG治疗不同病变严重程度的冠心病患者的临床效果及安全性相当。

Comparison of the Clinical Effects of PCI and CABG in the Treatment of Patients with Severe Coronary Heart Disease

ABSTRACT Objective: To compare the clinical efficacy and safety of PCI and CABG in the treatment of severe CHD with preoperative SYNTAX score>32. Methods: 50 cases of patients with severe CHD who had successfully performed CABG and had SYNTAX score > 32 before operation and 50 patients with severe CHD who had successfully performed PCI and had SYNTAX score > 32 before operation in the Department of Cardiology and Surgery of Xijing Hospital from 6 March 2017 to 20 May 2017 were selected for this study. They were divided into the PCI group and the CABG group. The general baseline data and in-hospital mortality were compared between the two groups. The Survival, cause of death, re-admission, angina pectoris, myocardial infarction and stroke were followed up by telephone in one year after operation. The improvement of quality of life was assessed by SF-12 and Seattle scales. Results: Compared with the CABG group, PCI group had lower heart rate, shorter hospitalization time, lower hospitalization cost and higher proportion of patients with history of PCI (P<0.05). At one year after operation, there was no significant difference in the improvement of cardiac function and the incidence of MACCE, SF-12 scale and SAQ scale scores between the two groups (P>0.05). Conclusion: The clinical efficacy and safety of PCI and CABG are comparable in the treatment of patients with coronary heart disease with different severity of lesions.