Takahashi T, Nakano S, Matsuda H, Taniguchi K, Matsumura R, Hirata N, Sakakibara T, Sakai K, Hirose H, Kawashima Y
First Department of Surgery, Osaka University Medical School, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Nov;38(11):2208-14.
We evaluated the late results of coronary bypass grafting (CABG) in 85 patients. The patients were divided into two groups according to preoperative MI size estimated by the Selvester QRS score; 24 with MI size of larger than 20% of LV muscle (group A; average 28 +/- 11%), and 61 with MI size smaller than 20% (group B; average 10 +/- 9%). New York Heart Association classes of both groups following CABG improved significantly (from 2.8 +/- 0.7 to 1.3 +/- 0.4 in group A; p less than 0.01, from 2.5 +/- 0.6 to 1.2 +/- 0.5 in group B; p less than 0.01). There was higher incidence of serious ventricular arrhythmias in group A than in group B (83% vs. 21%, p less than 0.01). In Group A, LVEF and LVESVI did not improve following CABG (from 17 +/- 9 to 16 +/- 8 mmHg, from 39 +/- 15 to 40 +/- 15%, from 66 +/- 28 to 69 +/- 40 ml/M2), while in Group B, those improved significantly (from 13 +/- 6 to 11 +/- 5 mmHg; p less than 0.01, from 53 +/- 14 to 58 +/- 10%; p less than 0.01, from 39 +/- 23 to 32 +/- 14 ml/M2; p less than 0.05). The exercise-to-rest LVSWI ratios increased significantly following CABG in both groups (from 86 +/- 25 to 160 +/- 56% in group A; p less than 0.05, from 92 +/- 31 to 140 +/- 37% in group B; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
我们评估了85例患者冠状动脉旁路移植术（CABG）的远期结果。根据塞尔维斯特QRS评分估计的术前心肌梗死面积将患者分为两组；24例心肌梗死面积大于左心室肌的20%（A组；平均28±11%），61例心肌梗死面积小于20%（B组；平均10±9%）。两组CABG术后纽约心脏协会心功能分级均显著改善（A组从2.8±0.7改善至1.3±0.4；p<0.01，B组从2.5±0.6改善至1.2±0.5；p<0.01）。A组严重室性心律失常的发生率高于B组（83%对21%，p<0.01）。在A组中，CABG术后左心室射血分数（LVEF）和左心室舒张末期容积指数（LVESVI）未改善（从17±9至16±8 mmHg，从39±15至40±15%，从66±28至69±40 ml/M2），而在B组中，这些指标显著改善（从13±6至11±5 mmHg；p<0.01，从53±14至58±10%；p<0.01，从39±23至32±14 ml/M2；p<0.05）。两组CABG术后运动与静息左心室每搏量指数（LVSWI）比值均显著增加（A组从86±25至160±56%；p<0.05，B组从92±31至140±37%；p<0.05）。（摘要截取自250字）
