摘要
目的 评价急性心肌梗死相关动脉弥漫或长病变置入长支架的临床疗效。方法 对10 5例急性心肌梗死 (AMI)患者行原发冠状动脉内支架术。将 5 7例AMI患者梗死相关动脉弥漫或长病变置入冠状动脉内支架长度≥ 2 0mm为长支架组 (A组 ) ,另 48例梗死相关动脉病变相对较短 ,置入支架长度 <2 0mm作为对照组 (短支架组 ,B组 )。比较两组之间的临床特征、冠状动脉造影情况及置入支架后的临床效果。结果 A组与B组之间有关年龄、性别、发病开始至心导管室时间、心肌梗死部位、心功能Killip分级、冠状动脉病变支数、具体梗死相关动脉病变血管和支架置入前梗死相关动脉血流TIMI分级 ,两组之间无统计学差异。A组患者侧支循环形成及经皮冠状动脉腔内成形术 (PT CA)后严重夹层形成明显多于B组。A组患者支架置入长度明显长于B组 [(2 6 0 2± 4 77)mm比(16 0 2± 2 40 )mm ,P <0 0 0 1]。两组之间置入支架直径无统计学差异。A组支架置入成功率为96 5 %,与B组 95 7%相似。支架置入后A组TIMI血流 3级为 93 3%,与B组的 91 7%相比 ,差异无显著性。A组中有 1例患者术后 3d支架处血栓形成。A组中 5 1例和B组中 41例患者术后随访 1～39个月 ,其中A组中 3例及B组中 4例因心绞痛再次入院行冠状动脉造影检查 ,A组
Objective To evaluate clinical efficacy of primary intracoronary long stenting in infarct related artery with long or diffuse disease after acute myocardial infarction (AMI) Methods The study population was composed of 105 consecutive patients with AMI and attempted primary stent implantation Fifty seven patients with long or diffuse infarct related artery disease after AMI were implanted long intracoronary stents which lengths were equal to or more than 20 mm (group A), and 48 patients with infarct related artery disease which stent lengths was less than 20 mm were as control group (group B) Results The age, gender, onset of chest pain, location of AMI, Killip class, the number of coronary artery disease, individual infarct related artery, TIMI grade before PTCA between two groups were not significantly different The collateral circulation,severe dissection after PTCA of group A were more than group B The length of stents in group A was longer than group B[(26 02±4 77)mm vs (16 02±2 40)mm, P <0 001], and stent diameter was not different in these two groups The procedural success rate of group A was similar to group B (96 5% vs 95 7%, P >0 05) TIMI grade 3 after stent placement between two groups was also not different (93 0% vs 91 7%, P >0 05) One patient of group A had in stent thrombosis after procedure Fifty one patients of group A and 41 of group B were followed up (from 1 to 39 months) after procedure, and 48 of group A and 37 of group B without cardiac events, such as death, AMI 3 patients of group A and 4 of group B were repeated coronary angiography because of chest pain There were 1 patient with restenosis and 2 with severe stenosis in non infarct related artery in group A, and 1 with restenosis and 3 with severe stenosis in non infarcted related artery in group B Conclusion Compared with short stenting in short lesions, long coronary stenting in long or diffuse infarct related artery disease after AMI is the same as a high procedure success rate, low complication and good clinical outcomes
出处
《中国介入心脏病学杂志》
2001年第4期173-176,共4页
Chinese Journal of Interventional Cardiology
关键词
心肌梗塞
支架
Myocardial infarction
Stenting
