摘要
【目的】探讨急性心肌梗死(AMI)患者行急诊经皮冠状动脉介入治疗(PCI)时的无复流现象的发生率及其病死率等临床指标状况。【方法】选择本院2006年3月至2007年12月之间的AMI行急诊PCI术的患者169例,分成无复流组及血流良好组,观察其病史、体格检查、血生化检查、术中记录及介入治疗方法之间的差异。【结果】有29(17.2%)例患者于PCI时出现了无复流象。两组在平均年龄、性别,合并糖尿病、高血压、心梗部位、病变长度、狭窄程度、单支病变比例等方面相比较无显著差别(P>0.0);在冠状动脉开通时间、CK-MB、cTnI水平、ST段回落程度、术中最大扩张压力及住院期间病死率方面均具有统计学意义(P<0.05)。【结论】AMI急诊PCI术后无复流现象的出现与无梗死前心绞痛史、冠状动脉开通时间长、CK-MB与cTnI水平高、先预扩张再支架、术中扩张压力大等可能有关,无复流患者病死率明显高于血流正常者,AMI急诊PCI术后出现无复流现象提示预后不良。
[Objective]To explore the incidence and the mortality of no reflow phenomenon in patients undergoing primary angioplasty（PCI） for acute myocardial infarction（AMI）,and to find out relative factors affecting no flow phenomenon after PCI in AMI patients.[Methods]A total of 169 patients undergoing primary angioplasty（PCI） for AMI in our hospital from Mar.2006 to Dec.2007 were enrolled in this study.All the patients were performed stenting in IRA and were divided into no reflow group and normal blood flow group.Case history,physical examination,blood laboratory findings,intraoperative recordings and the difference among methods of interventional treatment were observed.[Results]Among 169 patients,29 patients（17.2%） appeared no reflow phenomenon.There was no significant difference in mean age,sex,coexisting diabetes or hypertension,sites of AMI,the length of lesion,the degree of stenosis and the percentage of single artery lesion between two groups（P〉0.O5）.There were statistically significant differences in the time of coronary recanalization,the levels of CK-MB and cTnI,the reduction degree of ST segment,the highest extension pressure during PCI and the mortality in hospitalization between two groups（P〈0.05）.[Conclusion]No reflow phenomenon after PCI in AMI is related with factors as follows： no history of angina pectoris,longer time of coronary recanalization,high levels of CK-MB and cTnI,predilation before stenting,higher extension pressure,etc.The mortality of patients without reflow is obviously higher than that of patients with normal blood flow.No reflow phenomenon after emergency PCI in AMI may indicate poor prognosis.
出处
《医学临床研究》
CAS
2008年第11期1942-1945,共4页
Journal of Clinical Research
关键词
心肌梗塞/治疗
支架
myocardial infarction/TH
stents
