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目的:评估肌钙蛋白I(c Tn I)转归前后经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)与冠状动脉旁路移植术(coronary artery bypass grafting,CABG)治疗急性非ST段抬高心肌梗死(non-ST segment elevated myocardial infarction,NSTEMI)的有效性及安全性。方法:入选2008年1月1日至2013年4月30日就诊于我院并接受PCI或CABG治疗的NSTEMI患者329例,分为c Tn I转归前PCI干预组(A组)、c Tn I转归前CABG干预组(B组)、c Tn I转归后PCI干预组(C组)和c Tn I转归后CABG干预组(D组)。计算和比较各组的临床终点事件的发生率,再灌注策略对临床终点事件的优势比(OR)。结果:四组患者的完全血运重建率比较差异有统计学意义(P<0.05),B、C、D组显著高于A组(P<0.05),而B、C、D组之间比较无统计学差异(P>0.05)。术后24个月,再次血运重建率:A组12.9%和B组3.4%(OR=3.82,95%CI:1.03~16.60),A组12.9%和C组5.1%(OR=2.55,95%CI:1.29~6.61);MACCE事件发生率:A组14.1%和C组5.9%(OR=2.38,95%CI:1.15~5.79),以上结果比较差异均有统计学意义(P<0.05)。结论:c Tn I转归后行PCI治疗NSTEMI伴多支病变患者较c Tn I转归前PCI更有利于减少MACCE事件和再次血运重建的发生,c Tn I转归前行CABG术在降低血运重建发生率方面较优于PCI治疗。
PURPOSE: To evaluate the efficacy of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in the treatment of acute non-ST-segment elevation before and after troponin I (cTn I) Effectiveness and safety of non-ST segment elevated myocardial infarction (NSTEMI). Methods: A total of 329 patients with NSTEMI admitted to our hospital from January 1, 2008 to April 30, 2013 and undergoing PCI or CABG were divided into three groups: group A, c Tn I, group C, I before CABG intervention group (B group), cTnI after PCI intervention group (C group) and cTnI after CABG intervention group (D group). The incidence of clinical endpoint events and the odds ratio (OR) of reperfusion strategy to clinical endpoint events were calculated and compared. Results: The complete revascularization rate of the four groups of patients was significantly different (P <0.05), but significantly higher in group B, C and D than that in group A (P <0.05), while in group B, C and D No statistical difference (P> 0.05). At 24 months, the rates of revascularization were 12.9% in group A and 3.4% in group B (OR = 3.82, 95% CI: 1.03-16.60), 12.9% in group A and 5.1% in group C (OR = 2.55, 95 % CI: 1.29-6.61). The incidence of MACCE was 14.1% in group A and 5.9% in group C (OR = 2.38, 95% CI: 1.15-5.70). The differences were statistically significant (P <0.05) . Conclusions: Ctn I after PCI in the treatment of patients with NSTEMI with multivessel disease than c Tn I before PCI is more conducive to reduce the incidence of MACCE events and re-revascularization, c Tn I before the CABG surgery in the reduction The incidence of revascularization is superior to PCI.