我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

后球囊扩张血栓负荷程度对急性心肌梗死急诊介入治疗效果的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第5期
页码:
617-619
栏目:
临床研究
出版日期:
2011-10-25

文章信息/Info

Title:
Impact of repetitive balloon dilatations on short-term prognosis after stent implantation in patients with ST-elevation acute myocardial infarction
作者:
李东宝1; 华 琦2; 刘 志2; 李虹伟1; 陈 晖1
首都医科大学：1.北京友谊医院心内科,北京 100050，2.宣武医院心脏科,北京 100053
Author(s):
LI Dong-bao1;  HUA Qi2;  LIU Zhi2;  LI Hong-wei1;  CHEN Hui1
1.Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China, 2.Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
关键词:
血栓负荷; 心肌梗死; 急性; 经皮冠脉介入治疗; 后扩张
Keywords:
thrombus burden;  acute myocardial infarction;  percutaneous coronary intervention;  repetitive balloon dilatation
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:探讨再次球囊扩张对ST段抬高型急性心肌梗死（STEMI）患者急诊冠脉介入治疗（PCI）效果的影响。方法： 278例连续入选的STEMI患者在发病12 h内行PCI，根据支架后是否再次球囊扩张分为支架后扩张组（n=124）和支架后非扩张组(n=154)。每组再据血栓负荷程度分为低血栓负荷和高血栓负荷。结果： 后扩张组和非扩张组的支架后心肌梗死溶栓试验（TIMI）血流分级及血清磷酸激酶同工酶（CK-MB）峰值无统计学差异。与后扩张组+低血栓负荷相比，后扩张组+高血栓负荷支架后TIMI Ⅲ级血流的比率较低(64% vs. 90%，P<0.01)，CK-MB峰值［(286±166) U/L vs. (460±202) U/L,P<0.05］及主要不良事件发生率较高(12% vs. 2%,P＝0.01)。结论： 高血栓负荷的STEMI患者支架后球囊扩张与短期疗效和慢/无复流相关。
Abstract:
AIM:To investigate the impact of repetitive balloon dilatations on slow/no-reflow and short-term prognosis in patients with ST-elevation acute myocardial infarction (STEAMI). METHODS: Two hundred and seventy-eight consecutive AMI patients treated with primary percutaneous coronary intervention (PCI) within 12 h of symptom onset were divided into repetitive dilatation group (n=124) and nonrepetitive dilatation group (n=154). Each group was further divided into two subgroups according to the degree of thrombus burden. RESULTS: Repetitive balloon dilatation was present in 124 patients (44.6%) with no significant differences between groups in post-stent TIMI grade flow, infarction related artery (IRA) and thrombus burden. Compared with the repetitive dilatation in patients with low thrombus burden, repetitive dilatation in patients with high thrombus burden had a significantly lower rate of postrevascularization (TIMI grade III flow: 64% vs. 90%; P<0.01) and higher peak CK-MB values (286±166 vs. 460±202, P<0.05) and rate of MACE (12% vs. 2%, P=0.01). CONCLUSION: Repetitive balloon dilatation after stent implantation is related to short-term prognosis, myonecrosis and angiographic slow/no reflow of IRA in high-thrombus burden patients with STEAMI.

参考文献/References

[1]Aplin R,Tiede D,Lovitz C,et al.A regional system for delivery of primary percutaneous coronary intervention in ST-elevation myocardial infarction: STEMI-ST[J].Cloud.J Invasive Cardiol,2009,21(12):639-644.

[2]Bae JH,Kwon TG,Hyun DVV,et al.Predictors of slow flow during primary percutaneous coronary interventsion: an intravascular ultrasound virtual histology study[J]. Heart,2008,94(12):1559-1564.

[3]Kirma C,Izgi A,Dundar C,et al.Clinical and procedural predictors of no-reflow phenomenon after primary percutaneous coronary interventions[J]. Circ J,2008,72(5):716-721.

[4]Yip HK,Chen MC,Chang HW,et al.Angiographic morphologic features of infarct-related arteries and timely reperfusion in acute myocardial infarction: Predictors of slow flow and no-reflow[J].Chest,2002,122(4):1322-1332.

[5]Pan W,Wang LF,Yu JH, et al. Intracoronary nitroprusside in the prevention of the no-reflow phenomenon in acute myocardial infarction[J].Chin Med J(Engl),2009,122(22):2718-2723.

[6]Kusama I,Hibi K,Kosuqe M,et al.Impact of plaque rupture on infarct size in ST-segment elevation anterior acute myocardial infarction[J].J Am Coll Cardiol,2007,50(13):1230-1237.

[7]LI DB,Hua Qi,Liu Zhi,et al.Association between inflammatory mediators and angiographic morphologic features indicating thrombus formation in patients with acute myocardial infarction[J].Chin Med J (Engl),2009,122(15):1732-1737.

[8]Laskey WK.Brief repetitive balloon occlusions enhance reperfusion during percutaneous coronary intervention for acute myocardial infarction: a pilot study[J].Catheter Cardiovasc Interv,2005,65(3):361-367.

[9]Wang G,Zhang S,Joqqerst SJ,et al.Effects of the number and interval of balloon inflations during primary PCI on the extent of myocardial injury in patients with STEMI: does postconditioning exist in real-world practice?[J].J Invasive Cardiol,2009,21(9):451-455.

[10]Antoniucci D,Valenti R, Migliorini A,et al.Direct infarct artery stenting without predilation and no-reflow in patients with acute myocardial infarction[J].Am Heart J,2001,142(4): 684-690.

[11]Hong YJ,Jeong MH,Ahn Y,et al.Plaque prolapse after stent implantation in patients with acute myocardial infarction: an intravascular ultrasound analysis[J].JACC Cardiovasc Imaging,2008,1(4):489-497.

备注/Memo

备注/Memo:
收稿日期：2010-11-23.通讯作者：华琦，教授，主要从事高血压病、冠心病的研究Email:huaqi5371@medmail.com.cn 作者简介：李东宝，副主任医师Email:leetobo@sina.com 共同第一作者：刘志，主治医师，博士Email:Liuzhi7742@sina.com
更新日期/Last Update: 2011-11-03