冠状动脉内支架置入术治疗急性心肌梗死恢复期患者  

Coronary stenting to treat patients with myocardial infarction in recovery period

作　　者：葛斌[1] 吕树铮[2] 苏玉文[1] 解直彬 杨曙光[1] 迟东升 

机构地区：[1]中国人民解放军第88医院,山东泰安271000 [2]首都医科大学附属北京安贞医院心内科,北京100029

出　　处：《泰山医学院学报》2000年第2期102-103,共2页Journal of Taishan Medical College

摘　　要：目的　探讨冠状动脉内支架治疗急性心肌梗死恢复期患者近期、远期疗效。方法　对 11例急性心肌梗死恢复期患者行冠状动脉内支架治疗 ,梗死相关血管共 13支 ,A型病变 7支 ,B型病变 5支 ,C型病变 1支。结果　共置入支架 15只 ,成功率 10 0 % ,血管直径平均狭窄由术前 80 %～ 10 0 % ,降至术后 0± 10 %。平均随 11 4± 3 2个月 ,超声心动图检查左室射血分数、短轴缩短率、A E、术前为 41 6 %± 4 8%、2 9 8%± 5 6 %、1 36± 0 2 8;术后分别为 5 1 5 %± 9 3 % (P >0 0 5 )、34 5 %± 7 6 7% (P >0 0 5 )、0 93± 0 45 (P <0 0 5 )。99mT MIBI静息心肌灌注显像缺血心肌节段数 ,术前为 5 4± 2 2 ,术后为 3 3± 1 6 (P <0 0 5 )。硝酸甘油介入99mTc MIBI心肌灌注显像检查显示心肌缺血节段数术后较术前减少 (P <0 0 5 )。Objective: To study short and long term prognosis of patients with acute myocardial infarction in recovery period treated with intracoronary stents. Methods: 11 patients with acute myocardial infarction in recovery period were treated with intracoronary stents; There were 13 infarcted related arteries: 7 type A, 5 type B and 1 type C lesions in the arteries. Results: 15 stents were implanted. The narrow ratio of the luminal diameter of stented arteries before PTCA was 80%～100% but 0±10% after stenting. 15 stents were all implanted succssfully. All of the cases were followed up for 11.4±3.2 months. LVEF、FSand A/E were examinated by echocardiography before the procedure were 41.6%±4.8%、29.8%±5.6%、1.36±0.28, after the procedure were 51 5%±9 3%(P>0 05)、34 5%±7 67%(P>0 05)、0 93±0 45 (P<0 05) LVEF、PER、PFR examinated by 99m Tc PYP were 45 9%±6 58%、2 75±0 24、1 94±0 37 before the procedure, and after the procedure were 59 9%±5 08%(P>0 05)、2 69±0 46(P>0 05)、2 47±0 27 (P<0 05) respectively. 99m Tc MIBI resting and Nitroglycerin intervented myocardial perfusion imaging showed ischemic myocardial region decreased respectively. Conclusion: Introcoronary stenting can improve the short and long term prognosis of the patients with acute myocardial infarction in recovery period.

关 键 词：急性心肌梗死 冠状动脉支架置入术 预后 

分 类 号：R542.22[医药卫生—心血管疾病]