摘要
目的：考察放弃经皮冠状动脉介入（PCI）术治疗而接受药物综合治疗的冠心病合并心力衰竭患者的预后情况。方法：选择2010年12月-2012年7月在我院治疗的冠心病合并心力衰竭患者217例,按治疗方案分成手术组105例和非手术组112例。除基础治疗外,手术组患者在PCI手术前后均给予阿司匹林联合氯吡格雷治疗,非手术组患者长期给予阿司匹林联合氯吡格雷治疗。自患者出院至2015年5月,定期通过门诊、电话或复查冠脉造影方式随访,随访时间为24~38个月。记录随访期间全因死亡或因主要不良心脑血管事件造成再次住院和再次血运重建等事件。结果：手术组患者失访7例,中位随访时间为33个月;非手术组患者失访8例,中位随访时间为32个月。与手术组比较,非手术组患者心肌梗死、心力衰竭和死亡者例数较多,差异有统计学意义（P〈0.05）。手术组患者3年生存人数94例,生存率为95.9%;非手术组患者3年生存人数66例,生存率为63.5%,组间比较差异有统计学意义（P〈0.05）。与手术组比较,非手术组患者在随访期的生存时间较短,差异有统计学意义（P〈0.05）。结论：虽然仍不能得出药物治疗和PCI术治疗孰优孰劣的结论,但未行PCI术的患者3年生存率不容乐观;心肌缺血症状较重的冠心病患者应首先考虑PCI术。
OBJECTIVE：To investigate the prognosis of coronary heart disease complicated with heart failure patients abandoning percutaneous coronary intervention（PCI） and receiving drug comprehensive therapy. METHODS：From Dec. 2010 to Jul.2012,217 patients with coronary heart disease complicated with heart failure in our hospital were divided into operation group（105 cases）and non-operation group（112 cases）. Based on routine treatment,operation group was given aspirin combined with clopidogrel before and after PCI,and non-operation group was given aspirin combined with clopidogrel all the time. The patients were followed up regularly during discharging from hospital to May 2015 by outpatient,telephone and coronary angiography rechecking,lasting for 24-38 months. Death cases,readmission and revascularization again caused by main adverse cardio-cerebrovascular events were recorded during follow-up period. RESULTS：7 cases and 8 cases in operation group and non-operation group did not accept follow-up;median follow-up time was 33 months and 32 months,respectively. Case number of myocardial infarction,heart failure and death in non-operation group was more than operation group,with statistical significance（P0.05）. 94 patients survived in operation group in 3 years,with survival rate of 95.9%;66 in non-operation group,with survival rate of 63.5%;with statistical significance（P0.05）. The survival time of non-operation group was shorter than that of operation group,with statistical significance（P0.05）. CONCLUSIONS：Although we still cannot get the conclusion that PCI is a better treatment or drug therapy is better. But the survival rate of patients are not optimistic 3 years after abandoning PCI coronary heart disease patients with severe myocardial ischemia should choose PCI firstly.
出处
《中国药房》
CAS
北大核心
2016年第5期663-665,共3页
China Pharmacy
关键词
药物综合治疗
经皮冠状动脉介入术
冠心病合并心力衰竭
预后
生存率
Drug comprehensive therapy
Percutaneous coronary intervention
Coronary heart disease complicated with heart failure
Prognosis
Survival rate
