Effect of drug-eluting stent implantation and coronary artery bypass graft on short-term and mid-term quality of life in patients with multi-vessel coronary artery disease
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摘要: 目的:比较药物洗脱支架置入术与冠状动脉 (冠脉) 旁路移植术对多支病变患者近期和中期生活质量的影响。方法:选择经冠脉造影证实为多支病变的患者209例, 根据血运重建方式分为药物洗脱支架置入术组和冠脉旁路移植术组。采用SF-36生活质量调查表对患者术前、术后1个月及1年定期随访。结果:两组基线情况差异无统计学意义。两组患者组内比较:8个维度中除总体健康状况外, 其余7个维度生活质量评分在术后1个月及术后1年均较术前有明显提高 (均P<0.05), 但术后1年评分与术后1个月相比差异无统计学意义。两组患者组间比较:术前两组评分各个维度差异无统计学意义;术后1个月及术后1年冠脉旁路移植术组在机体疼痛 (t=2.279 6和2.450 7, P<0.05)、躯体功能 (t=2.300 2和3.259 8, P<0.05) 两个维度评分高于药物洗脱支架置入术组, 其余6个维度两组患者评分差异无统计学意义。结论:药物洗脱支架置入术和冠脉旁路移植术均可有效改善多支病变患者近中期生活质量, 其获益来自血运重建本身;冠脉旁路移植术在缓解机体疼痛及改善躯体功能方面优于药物洗脱支架置入术。Abstract: Objective: To provide a comparision of the short-term and mid-term quality of life (QOL) in patients with multivessel coronary disease after coronary artery bypass graft (CABG) versus drug-eluting stent (DES) implantation for percutaneous coronary intervention (PCI).Method: All 209patients with muti-vessel coronary disease (MVD) were divided into CABG group (n=105) and DES group (n=104).The Short-Form 36 (SF-36) self-administered quality of life questionnaires were applied at baseline, 1month and 1year later.Result: Baseline data had no statistical difference between the two groups.In both two groups there were significant improvements in QOL 1month and 1year after revascularization, but no statistical difference was observed between 1 month and 1year.The CABG group showed significant superiority over the DES group in terms of bodily pain and physical functioning both 1month and 1year later.Conclusion: Both CABG and DES could improve the short-term and midterm quality of life in patients with MVD, CABG is superior over DES in terms of bodily pain and physical functioning.
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[1] GRAPOW M T, VON WATTENWYL R, GULLER U, et al.Randomized controlled trials do not reflect reality:real-world analyses are critical for treatment guidelines[J].Thorac Cardiovasc Surg, 2006, 132:5-7.
[2] MORISKY D E, GREEN L W, LEVINE D M.Concurrent and predictive validity of a self-reportedmeasure of medication adherence[J].Med Care, 1986, 24:67-74.
[3] 李裕舒, 黎明.左主干及3支病变的血运重建策略-SYNTAX研究解读[J].临床心血管病杂志, 2009, 25 (2):83-84.
[4] RICARDO D V, WHADY H, BERNARD J, et al.Effect of complete revascularization on 10-year survival of patients with stable multivessel coronary artery disease:MASSⅡtrial[J].Circulation, 2012, 126:158-163.
[5] FAVARATO M E, HUEB W, BODEN W E, et al.Quality of life in patients with Symptomatic multivessel coronary artery disease:a comparative posthoc analyses of medical, angioplasty or surgical strategies-MASSⅡtrial[J].Int J Cardiol, 2007, 116:364-370.
[6] HANNAN E L, RACZ M, HOLMES D R, et al.Impact of completeness of percutaneous coronary intervention revascularization on long-term outcomes in the stent era[J].Circulation, 2006, 113:2406-2412.
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