摘要
目的探讨择期经皮冠状动脉介入(PCI)治疗不同时机开通非梗死相关动脉(Non-IRA)对ST段抬高型心肌梗死(STEMI)患者预后的影响。方法回顾性分析伊宁市第十一医院心内科2015年8月至2016年12月期间合并多支血管病变(MVD)的STEMI住院患者160例,其中男性105例,女性55例,年龄(63.1±9.6)岁。根据患者择期PCI干预Non-IRA的时机不同,分为≤14 d组(n=92)和30~60 d组(n=68),比较两组冠状动脉造影、Non-IRA平均支架植入数量和住院期间主要并发症,术后对患者随访6个月,比较两组术后1个月和6个月主要不良心血管事件(MACEs)发生率。根据数据类型分别采用t检验和x^2检验比较组间差异。结果两组患者Non-IRA支架植入数量差异无统计学意义(P>0.05);≤14 d组住院期间PCI相关并发症较30~60d组明显增加,差异具有统计学意义(18.5%vs7.4%;P=0.034)。两组术后1个月MACEs差异无统计学意义(P>0.05),术后6个月30~60 d组MACEs发生率较≤14 d组显著降低,差异具有统计学意义(5.9%vs 16.3%;P=0.042)。结论 30~60 d择期干预Non-IRA降低住院期间主要并发症和术后6个月发生MACEs的风险,可能为择期PCI干预Non-IRA的较理想时机。
Objective To investigate the effect of different waiting times of elective percutaneous coronary intervention（PCI）for non-infarct related artery（Non-IRA）on the prognosis in patients with ST segment elevation myocardial infarction（STEMI）.Methods A retrospective study was carried out on 160 STEMI patients with multivessel disease hospitalized in our department from August 2015 to December 2016.They were 105 males and 55 females,at an age of（63.1 ±9.6）years.According the waiting times for elective PCI,they were assigned into ≤14 d group（n=92）and 30-60 d group（n=68）.The results of coronary angiography,numbers of Non-IRA stent implantation and the main complications during hospitalization were compared.The patients were followed up for 6 months.The incidence of major adverse cardiovascular events（MACEs）were compared between the 2 groups in 1 and 6 months after PCI.The differences between the groups were compared by Student＇s t test and Chi-square test for different data types.Results There was no significant difference in the implanted stent number between the ≤14 d group and 30-60 d group（P〉0.05）.The incidence of PCI related complications during hospitalization was obvious higher in the ≤14 d group than the 30-60 d group（18.5%vs 7.4%;P=0.43）.There was no obvious difference in the incidence of MACEs in 1 month after PCI between the 2 groups,but the incidence was notably lower in the 30 -60 d group in 6 months（5.9% vs 16.3%;P=0.042）.Conclusion Waiting time of 30-60 d reduces the risks for PCI-related complications during hospitalization and for MACEs in 6 months after PCI,and which might be an optional time for elective PCI in treatment of Non-IRA.
出处
《中华老年多器官疾病杂志》
2017年第11期841-845,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
心肌梗死
血管病变
择期经皮冠状动脉介入
多支血管病变
myocardial infarction
vascular lesions
elective percutaneous coronary intervention
multivessel disease
