摘要
目的分析急性心肌梗死(AMI)患者梗死相关动脉自发再通现象的临床和造影特点,并观察其对患者30天预后的影响.方法连续入选112例未予静脉溶栓、直接行急诊冠状动脉造影及急诊经皮冠状动脉介入治疗的ST段抬高的AMI患者,根据心肌梗死溶栓治疗临床试验(TIMI)血流分为自发再通组31例(前向血流TIMI 2～3级)和非自发再通组81例(前向血流TIMI 0～1级),分析其临床、造影、经皮冠状动脉介入治疗以及30天预后特点.结果自发再通组共31例(27.7%),与非自发再通组比较,自发再通组肌酸激酶和肌酸激酶同工酶峰值明显降低(P＜0.01)、室壁运动异常比例低(P＜0.05)、30天时的死亡率明显降低(P＜0.01),左室射血分数明显提高(P＜0.05).结论 AMI中梗死相关动脉的自发再通能够缩小心肌梗死面积,改善心功能,降低30天时的死亡率.
Objective To analyse the clinical and angiographic characteristics of spontaneous reperfusion(SR) in AMI,and to evaluate its effect on short-term prognosis.Methods 112 consecutive AMI patients without intravenous thrombolytic therapy received emergent coronary angiography and primary PCI.The patients were divided into SR group(antegrade TIMI grade 2-3 flow) and non-SR group(antegrade TIMI grade 0-1 flow). The clinical, angiographic and prognostic features of the patients were analyzed.Results 31 patients (27.7%) were in SR group,and there was no significant differentce in base-line clinical characteristics between the two groups.Compared with non-SR group,peak values of CK and CK-MB , Ventricular wall motion abnormality and mortality were lower in SR group,ejection fraction was higher in SR group.Logistic regression analysis showed that there was good correlation between SR and peak value of CK,collaterals, ventricular wall motion abnormality and pre-dilation in PCI.Conclusion SR decreased infarction size,improved heart function and reduced 30-day mortality.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2005年第6期547-549,共3页
Chinese Journal of Cardiology
关键词
急性心肌梗死
动脉自发再通
短期预后
肌酸激酶
心功能
Myocardial infarction
Angioplasty,transluminal,percutaneous coronary
Spontaneous reperfusion
