侧支循环对急性ST段抬高心肌梗死未及时血运重建患者心功能的影响  

Effects of collateral circulation on ventricular function of patients with ST-segment-elevation myocardial infarction treated with delayed percutaneous coronary intervention

作　　者：朱华刚[1] 孟帅[1] 贾若飞[1] 杨铎[1] 浦连美 金泽宁[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所急诊科,100029

出　　处：《心肺血管病杂志》2014年第6期791-794,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:评价择期经皮冠状动脉介入治疗(PCI)时,冠状动脉造影显示的侧支循环对于急性ST段抬高心肌梗死未能及时血运重建患者心功能的影响。方法:纳入2012年4月至2014年2月间,在北京安贞医院急诊科就诊未能行急诊介入治疗的ST段抬高型心肌梗死(STEMI)患者76例,入院后均择期行冠状动脉造影和介入治疗,成功开通罪犯血管。根据择期冠状动脉造影结果按Rentrop方法评价侧支循环情况,分为有侧支循环组(n=33)和无侧支循环组(n=43)。分别于术后24小时内和术后30天应用超声心动图评价心功能情况。结果:PCI术后24小时内,有侧支循环组和无侧支循环组左心室射血分数差异无统计学意义(P>0.05);两组间出现室壁瘤的比例,差异无统计学意义(P>0.05)。术后30天门诊随访,有7例患者失访。术后30天超声结果显示两组的左心室射血分数和室壁瘤的发生比例差异没有统计学意义(P>0.05)。结论:择期冠状动脉造影时显示的冠状动脉侧支循环可能与急性ST段抬高心肌梗死未及时血运重建患者择期PCI术后的心功能无关。Objective： The purpose of this study was to determine whether the presence of coronary collateral flow, as evidenced by delayed angiography, has a beneficial effect on left ventricular function in ST-seg- ment-elevation myocardial infarction （STEMI） treated by means of delayed percutaneous coronary intervention （PCI）. Methods： Between April 2012 to February 2014, 76 patients with STEMI treated with delayed PCI were analyzed. According to the Rentrop grade, these patients were divided into 2 groups： collateral circulation group （n = 33 ） and non-collateral circulation group （n = 43 ）. They left ventricular function was evaluated within 24 hours after PCI and 30 days later. Results：Comparison of 2 groups didn＇t show any difference on left ventricular ejection fraction and aneurysm formation within 24 hours and 30 days after delayed PCI. （ P 〉 0. 05 ）. Conclusion ： The presence of angiographically detectable collaterals in delayed PCI maybe has no protective effect on left ventricular function in ST-segment-elevation myocardial infarction （STEMI） treated by delayed PCI.

关 键 词：冠状动脉疾病 心肌梗死 侧支循环 

分 类 号：R54[医药卫生—心血管疾病]