心肌梗死溶栓后再发心肌缺血患者支架植入疗效观察  

Analysis of coronary stenting treatment after thrombolysis in AMI

作　　者：闫忠政[1] 吴天兵[1] 全劲松[1] 苑丽丽[1] 吴波[1] 

机构地区：[1]沈阳市红十字会医院心内科,辽宁沈阳110013

出　　处：《中国民康医学》2009年第22期2775-2776,2826,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨急性心肌梗死(AMI)溶栓后再发心肌缺血患者冠状动脉病变特征和冠脉内支架植入疗效。方法:AMI静脉溶栓后再发心肌缺血病例182例,溶栓后再行冠状动脉造影(CAG)及冠脉内支架植入治疗。术前测定IRA、non-IRA病变程度及TIMI血流分级,术后及随访期间检测左室射血分数(LVEF),统计随访期LVEF和心血管事件(MACE)。结果:溶栓结局分为溶栓再通组(123例,A组)及未通组(59例,B组)。A组的IRA残留严重病变例数和残留严重病变平均狭窄程度均明显少于B组,而TIMI 3级血流例数均明显多于B组(P均<0.05～0.01)。随访期间A组的MACE发生率少于B组,而左室射血分数明显高于后者(P均<0.05～0.01)。结论:AMI静脉溶栓后再发心肌缺血患者常常伴有较严重的冠脉病变,特别是溶栓未通患者,行冠脉内支架治疗疗效较好。Objective： To evaluate coronary lesion trait and curative effect of stenting treatment on re - emerging mycardial ischemia after thrombolysis in acute myecardia infarction. Methods： 182 cases of thrombolysis in AMI patients who had re - emerging myocardial is chemia under sentiny trentment after AMI. They were divided into intravenous thrombolytic patency group （group A）, nonpatency group（group B）follow - up nas 6 - 18 months. Left ventricnlar ejection fraction（LVEF）was measured by ultrasonic cardiogram（uug）. Before and after follow - up. The degree of IRA or non - IRA and the degree of TIMI. Were reasured before follow - up. Results： Both group A and group B had a large proportion of IRA seriou residual stenosis,before stenting treatment, and degree of stenosis was higher in group B than in groupA, and degree of T IMI was lower in group B （P 〈 0.01 ）. The cases（97.4% ） were successfully senting and successful rate of senting and occuring rate of serious non - IRA stenosis hadn＇t significant difference（ P 〉 0.05）. 161 cases（91% ） were follow - up in 6 - 18 months and there was on death. The oeeuring rate of cardiovacuiar incident was loweriy 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 〈 0.01 ）. Conclusion： There are alarge proportion of IRA and some non - IRA serious residual stenosis afeor thrombolysis in AMI. So it is necessary, saftey and highy successful rate to sent to serious stenosis IRA and non- IRA.

关 键 词：急性心肌梗死 静脉溶栓治疗 支架 

分 类 号：R542.22[医药卫生—心血管疾病]