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|本期目录/Table of Contents|

延迟冠状动脉介入治疗对急性心肌梗死患者预后的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第6期
页码:
675-677
栏目:
临床研究
出版日期:
2006-12-25

文章信息/Info

Title:
Clinical assessment of benefits of delayed percutaneous transluminal coronary intervention in patients with acute myocardial infarction
作者:
王岳松1; 章萍1; 王学忠1; 杨志健2
1．马鞍山市人民医院心内科， 安徽 马鞍山 243001； 2. 江苏省人民医院心脏科，江苏 南京210029
Author(s):
WANG Yue-song;  ZHANG Ping;  WANG Xue-zhong;  YANG Zhi-jian
Department of Cardiology, Renmin Hospital of Maanshan City, Maanshan, Anhui 243001, China
关键词:
心肌梗死; 急性; 经皮冠状动脉介入治疗; 预后
Keywords:
myocardial infarction; acute; percutaneous coronary intervention; prognosis
分类号:
R541.54
DOI:
-
文献标识码:
A
摘要:
目的 探讨延迟经皮冠状动脉介入治疗（PCI）对急性心肌梗死（AMI）患者预后的影响。方法 对38例ST段抬高的AMI患者经静脉溶栓后常规行延迟PCI（延迟组），然后与经静脉溶栓后药物保守治疗（对照组）的34例患者进行对比分析，观察住院期间和随访6个月时的临床不良事件和超声心动图的变化。结果 与保守治疗比较，常规施行延迟PCI可以降低住院期间的病死率（0% vs 15%，P<0.05），缩短平均住院时间（15 d vs 28 d，P<0.05），减少住院期间心绞痛发作（5% vs 35%，P<0.05）及再次心肌梗死（0% vs 9%，P<0.05）；还可以明显降低6个月病死率（3% vs 12%，P<0.05）和再住院率（8% vs 26%，P<0.05），防止左心室进一步重构，改善患者心脏功能。结论 常规施行延迟PCI可以提高AMI患者住院期间和6个月的治疗效果，改善临床预后。
Abstract:
AIM To evaluate the role of routine delayed percutaneous coronary intervention (PCI)after thrombosis in the management of patients with STsegment elevation myocardial infarction (STEMI). METHODS Thirty-eight patients with STEMI who underwent routine delayed PCI after thrombosis (therapy group)and 34 patients with STEMI who were given conservative strategy after thrombosis (control group) were enrolled in this study and were compared in major adverse clinical events (MACE)and cardiac structure and function by echocardiography during hospitalized period and 6month followup. RESULTS Compared with conservative strategy after thrombosis, routine delayed PCI after thrombosis decreased the inhospital mortality (0% vs 15%), shortened the average hospital stay time (15 d vs 28 d), prevented recurrent angina (5% vs 35%)and reinfarction (0% vs 9%), produced lower mortality (3% vs 12%)and rehospitalization (8% vs 26%) during the followup period and prevented further left ventricle remodeling. CONCLUSION Routine delayed PCI after thrombosis may prevent MACE and improve immediate results and 6month prognosis of patients with STEMI.

参考文献/References

［1］ 颜红兵，柯元南. 美国冠心病诊断与治疗指南［A］. 北京：环境与科学出版社，2004.317.

［2］ Steg PG，Bonnefoy E，Chabaud S, et al. Impact of time to treatment on mortality after prehospital fibrinolysis or primary angioplasty：data from the CAPTIM randomized clinical trial［J］. Circulation, 2003，108（23）：2851-2856.

［3］ Keeley EC，Boura JA，Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction：a quantitative review of 23 randomised trials［J］. Lancet， 2003，361(9351)：13-20.

［4］ Caspi A，Gottlieb S，Behar S. Delayed percutaneous transluminal coronary angioplasty after acute myocardial infarction［J］. Int J Cardiol, 1998, 63（3）:199-204.

［5］ Kanamasa K，Ishikawa K，Ogawa I，et al. Prevention of left ventricular remodeling by percutaneous transluminal coronary angioplasty performed 24 hours after the onset of acute myocardial infarction［J］. J Thromb Thrombolysis，2000, 9（1）: 47-51.

［6］ Pizzetti G，Belotti G，Margonato A，et al. Coronary recanalization by elective angiophsy prevents ventricular dilation after anterior myocardial infarction［J］. J Am Coll Cardiol, 1996, 28（4）: 837-845.

备注/Memo

备注/Memo:
收稿日期：2005-10-14.作者简介：王岳松，副主任医师，硕士 Tel：(0555)8222395 Email:wys16601@126.com
更新日期/Last Update: