摘要
目的 探讨急性心肌梗死 (AMI)溶栓后延迟病变冠状动脉支架置入疗效及并发症。方法 AMI病例 16 0例 ,分为静脉溶栓再通 (A )组和静脉溶栓未通 (B)组 ,于 AMI后 3～ 15日行冠状动脉内支架置入治疗 ,随访 6个月 ,均于随访前后查超声心动图 (UCG) ,测定左心室射血分数 (L VEF)。结果 A、B两组均有很高比例的梗死相关血管(IRA)和一定比例的非梗死相关血管 (non- IRA)残留严重狭窄。IRA狭窄程度 B组比 A组严重 (P<0 .0 5 )。成功置入支架 15 2例 (95 % ) ,A、B两组间手术成功率和严重并发症发生率无显著性差异。 138例 (90 .7% )随访 6个月 ,随访期内无死亡病例。与 B组比较 ,A组心血管事件发生率低 (P<0 .0 5 ) ,A组随访期间 L VEF较随访前增加 (P<0 .0 5 ) ,较 B组高 (P<0 .0 5 )。结论 AMI病例溶栓后存在严重的 IRA和 non- IRA残留狭窄 ,行冠状动脉内支架置入是必要的、安全的 ,手术成功率高 。
Objective To evaluate the effect and complication of coronary stenting after acute myocardial infarction (AMI). Methods 160 AMI patients with re-emerging myocardial ischemia underwent stenting trentment in 3-15 days after AMI. They were divided into intravenous thrombolytic patency group (group A),non-patency group (group B).Follow-up was 6 months. Left ventricular ejection fraction(LVEF) was measured by ultrasonic cardiogram (UCG) before and after follow-up. Results Both group A and group B had a large proportion of IRA and some non-IRA serious residual stenosis, and degree of stenosis was higher in group B than in group A(P< 0.05). 152 cases (95%) were successfully stenting , and successful rate of stenting and occurring rate of serious complications hadn't significant difference. 138 cases (90.7%) were follow-up in 6 months and there was no death. The occurring rate of cardiovascular incident was lower in group A than in group B(P<0.05). LVEF in group A was higher at the end of follow-up than before follow-up and in group B(P<0.05).Conclusion It is necessary, safety and higher successful rate to stent for serious stenosis IRA and non-IRA of re-emerging myocardial ischemic cases after AMI. It can improve prognosis of patients. Thrombocytic patency cases can make more profit on it.
出处
《中国心血管杂志》
2003年第4期260-262,共3页
Chinese Journal of Cardiovascular Medicine
关键词
急性心肌梗死
梗死相关血管
支架
左心室射血分数
Acute myocardial infarction
Infarct artery
Stent
Left ventricular ejection fraction.
