冠心病多支血管病变部分血运重建优化药物治疗后非干预血管病变

冠脉造影随访

王智 唐强 刘坤 刘秀敏 史震涛

北京大学首钢医院心内科（100144）

摘要 目的：研究冠心病多支血管病变（multivessel coronary artery disease ，MVD）部分血运重建优化药物治疗（optimizing drug therapy，OMT）对非干预血管病变的临床意义。方法：对于256例冠心病多支血管病变患者进行部分血运重建（incomplete coronary revascularization，IR）+标准优化药物治疗1年后通过冠脉造影（CAG）资料对未干预血管病变狭窄程度进行对比分析。结果：256例部分血运重建患者非干预血管病变冠脉造影结果显示，所有临床指标达标患者190例，其中182例（95.8%）患者病变狭窄程度较前减轻或无变化；8例（4.2%）患者病变狭窄程度较前加重，再次行血运重建。有临床指标未达标的患者66例，其中56（84.8%）患者病变狭窄程度较前减轻或无变化；10例（15.2%）患者病变狭窄程度较前加重，再次行血运重建。临床指标达标患者与未达标患者总有效性182/190比56/66（95.8%对84.8%）与总无效性8/190比10/66（4.2%对15.2%）具有显著性差异。结论：冠心病多支血管病变部分血运重建患者优化药物治疗对于未干预血管病变具有明显临床意义。

关键词 冠心病 多支病变 部分血运重建 优化药物治疗 非干预血管病变冠脉造影

The assessment of non intervention vascular lesions by OMT under

coronary angiography to the multivessel coronary artery disease

WANG Zhi , TANG Qiang, LIN Kun, LIU Xiumin, SHI Zhentao

（Department of Cardiology, Peking University Shougang Hospital, Beijing 100144, China）

Abstract -ive: To study the clinical significance of incomplete coronary revascularization (IR) and optimizing drug therapy (OMT) to non intervention vascular lesions of multivessel coronary artery disease(MVD). Methods: 256 MVD patients were given IR and OMT, the degree of stenosis of non intervention lesions are compared by coronary angiography ( CAG ) one year later.Results: 190 patients get the clinical targets of OMT , and among them, there are 182 patients degree of stenosis of non intervention vascular lesions are reduced or no change; and 8 patients with lesions of the degree of stenosis than the previous exacerbations, undergoing revascularization. 66 patients don’t get the clinical targets of OMT, and 56 patients’ degree of stenosis of non intervention vascular lesions are reduced or no change; and 10 patients with lesions of the degree of stenosis than the previous exacerbations, undergoing revascularization. The total effective ratio of Clinical targets of patients and not up to are 182 patients to 56 patients (95.8% to 84.8%) respectively ;and the total effectiveness ratio are 8 patients to 10 patients (4.2% to 15.2%). There are significant difference among them(P