急性心肌梗死冠脉病变对介入治疗后ST段变化及预后的影响  

Effect of coronary artery lesions in patients of acute myocardial infarction on ST segment changes after interventional therapy and prognosis

作　　者：张云[1] 黄文珠[1] 许端敏[1] 陈畅[1] 

机构地区：[1]汕头大学医学院第一附属医院心内科,广东省汕头515041

出　　处：《中国基层医药》2013年第15期2241-2243,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省科学事业计划项目（2010B031600274）

摘　　要：目的 探讨急性心肌梗死患者冠脉病变对经皮腔内冠脉介入（PCI）治疗后ST段回落（STR）及预后的影响.方法 对380例急性心肌梗死患者进行冠脉造影及PCI术,据PCI术前及术后1 hST段变化分为STR组（STR≥50％）,STR不良组（STR＜ 50％）.分析不同冠脉病变患者与PCI术后STR及住院随访期间临床预后关系.结果 冠脉多支病变、近段病变、PCI术后STR率低于冠脉单支病变、中远段病变（P＜0.05）；近段冠脉病变患者住院期间主要心脏事件发生率、左室舒张期末内径（LVEDd）明显高于中远段病变,而左室射血分数（LVEF）低于中远段（P＜0.01）.随访期间冠脉多支病变与单支病变LVEF、LVEDd值差异有统计学意义（P＜0.01）.结论 急性心肌梗死患者PCI术后冠脉多支病变、近段病变与STR回落及住院随访期间临床预后有明显相关性.Objective To explore the influence of acute myocardial infarction（AMI） patients with coronary lesions to the ST segment resolution （STR） and clinical prognosis after percutaneous coronary intervention （PCI）. Methods 380 patients with AMI were detected twice each hour for the situation of STR,before and after coronary angiography and PCI. According to the STR, the patients were divided into STR （ 〉1 50% ） group and no STR （ 〈 50% ） group. The relationship, between STR and clinical prognosis of hospitalization or follow up were analyzed. Results The STR rate of patients with coronary muhivessel disease or proximal lesions after PCI was lower than the rate of patients with coronary single vessel disease or distal lesions （P 〈 0.05）. The incidence rate of major cardiac events and LVEDd during hospitalization in patients with proximal coronary lesions was obviously higher than patients with distal lesions, while LVEF was lower than distal lesions （P 〈 0.01 ）. It had no significant differences in LVEF, LVEDd between coronary multivessl disease and single vessel disease during follow up （ P 〈 0.01 ）. Conclusion It has significant relationship between coronary multivessel disease, proximal coronary, STR resolution in patients with AMI after PCI and the prognosis during hospitalization and follow up.

关 键 词：心肌梗死 冠状动脉疾病 血管成形术 经腔 经皮冠状动脉 心电描记术 

分 类 号：R542.22[医药卫生—心血管疾病]