冠状动脉慢性完全闭塞患者经PCI治疗后的临床效果及成功的影响因素
The clinical effect of PCI treatment in chronic total occlusion of coronary artery patients and the factors affecting the success

赵东晖.冠状动脉慢性完全闭塞患者经PCI治疗后的临床效果及成功的影响因素[J].内科急危重症杂志,2014,(6):

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英文关键词:Coronary chronic total occlusion Percutaneous coronary intervention Curative effect

基金项目:上海市卫生局青年课题（20134y116）

作者	单位	E-mail
赵东晖	首都医科大学附属北京安贞医院上海市奉贤区中心医院基金：上海市卫生局青年课题y	zhaodonghui3486@126.com

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中文摘要:

目的：评估介入治疗(PCI)对冠状动脉慢性完全闭塞(CTO)患者的治疗效果,并探讨影响介入治疗效果的相关因素。方法：回顾性分析我院心内科近期收治的586例经PCI治疗的CTO患者的临床资料。比较CTO患者在院内的介入治疗效果及相关影响因素。结果：PCI的成功率为80%。术中并发症较少(7.7%),其中术中冠状动脉穿孔8例,心包穿孔及心包压塞5例,支架血栓形成4例,严重心律失常(房扑、房颤、室性心动过速及室颤)22例,手术相关心绞痛6例。影响介入治疗成功的患者自身因素有年龄(P=0.034),高血压史(P=0.041),糖尿病史(P=0.032),发病至治疗的时间(P=0.008)；病变相关因素有冠脉闭塞部位(P<0.05)、冠脉分支迂曲程度(P=0.015)、闭塞血管远端缺如(P=0.044)及合并钙化(P=0.007)。结论：CTO患者进行PCI治疗的效果良好。患者的个人病史、病变特点、及治疗实施是否及时是决定介入治疗是否成功的关键因素。

英文摘要:

Objective: To evaluate the effect of percutaneous coronary intervention (PCI) on coronary chronic total occlusion (CTO) patients, and to explore the influencing factors of interventional therapy. Methods: The clinical data of 586 cases with CTO who accepted PCI in the department of Cardiology of our hospital were retrospectively analysed. The effects and influencing factors were compared and analysed. Results: The success rate of PCI was 80%. Intraoperative complications were mild (7.7%), including 8 cases of coronary artery perforation during operation, 5 cases of pericardium perforation and cardiac tamponade, 4 cases of stent thrombosis, 22 cases of severe arrhythmia (atrial flutter, atrial fibrillation, ventricular tachycardia and ventricular fibrillation Heartbeat), and 6 cases of operation related angina. The patients’ own factors which influenced the treatment were age (P=0.034), history of hypertension (P=0.041), history of diabetes mellitus (P=0.032), and the length of time from onset to treatment (P=0.008). The factors related with the lesions included the location of coronary occlusion (P<0.05), the tortuosity of coronary artery (P=0.015), the distal defect of vascular occlusion (P=0.044), and calcification (P=0.007). Conclusion: PCI has a good effect on patients with CTO. The patients’ personal history, pathological features of the disease and the time to get treated are key factors that influence the success of PCI.