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Title:: Comparison of reperfusion therapy at different time windows in patients with acute myocardial infarction

作者:: 严文英; 王燕妮; 西安交通大学第一附属医院心内科，陕西西安 710061

Author(s):: YAN Wen-ying; WANG Yan-ni; Department of Cardiovasology, First Affiliated Hospital, Xian Jiaotong University, Xi’an 710061, Shaanxi, China

关键词:: 不同时段再灌注; 终点事件; 心功能

Keywords:: different time of reperfusion; endpoint event; ventricular function

分类号:: R541.4

DOI:: -

文献标识码:: A

摘要:: 目的: 通过不同时段再灌注对急性ST段抬高型心肌梗死（ASTEMI）患者出院12个月随访，探讨不同时段再灌注方法对ASTEMI的终点事件、心功能预后的影响。方法: 选择2006年1月~2008年1月，我科住院ASTEMI患者238例。根据是否接受冠状动脉介入治疗（PCI）及心肌再灌注时间分为3组：急诊PCI组（胸痛<12 h）89例；晚期PCI组（胸痛>24 h）86例；保守组（胸痛>24 h）63例。分别记录3组的临床资料,出院后12个月进行电话随访，预约心动超声检查。结果: ①3组出院12个月主要终点事件心源性死亡率有显著性差异(P<0.05),次要终点事件心肌梗死、心力衰竭再入院率均有显著性差异(P<0.05)。②出院12个月急诊PCI组较晚期PCI组心功能的左室射血分数（LVEF）显著增加、左室舒张末内径（LVEDD）显著缩小,急诊PCI组vs.保守治疗组LVEF、LVEDD均有显著性差异（P<0.05）。结论: 在降低终点事件，提高心功能方面，急诊PCI预后优于晚期PCI，晚期PCI优于保守治疗。

Abstract:: AIM: To follow up patients with acute ST-segment elevated myocardial infarction (ASTEMI) by different reperfusion time 12 months after discharge from the hospital and to investigate the influence of different reperfusion time on ASTEMI endpoint events and prognosis of the heart function. METHODS: Two hundred and thirty-eight ASTEMI cases were divided into 3 groups by percutaneous coronary intervention (PCI) treatment, non-PCI treatment and times of reperfusion: emergency PCI, within 12 hours after chest pain, 89 cases; delayed PCI, over 24 hours after chest pain, 86 cases; and conservative treatment, over 24 hours after chest pain, 63 cases. Clinical data of the three groups were registered, follow up was conducted in all the patients by telephone 12 months after discharge from the hospital, and an echocardiography examination was arranged for each case. RESULTS: Significant difference was found in the primary endpoint event (cardiac death) 12 months after the discharge (P<0.05) and in secondary endpoint events (re-admission rate of AMI and heart failure) among the three groups (P<0.05). Significant difference was observed in LVEF and LVDd between emergency PCI group and delayed PCI group 12 months (P<0.05) and between emergency PCI group and conservative group (P<0.05). There was significant difference in 6-minute-walk test among the three groups (P<0.05). CONCLUSION: To reduce the endpoint events and enhance the heart function, emergency PCI is superior to delayed PCI and delayed PCI is better than conservative treatment.

参考文献/References

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不同时段再灌注治疗急性心肌梗死疗效的比较

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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