冠状动脉腔内支架植入术对于急性心肌梗死的疗效  

Therapeutic effect of coronary artery stent implantation on acute myocardial infarction

作　　者：梁敏 

机构地区：[1]广西桂平市人民医院心血管内科,广西桂平537200

出　　处：《心血管康复医学杂志》2016年第1期97-100,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：探讨急性心肌梗死患者采用冠状动脉腔内支架植入术（CASI）的疗效。方法：89例急性梗死患者根据自愿选择被分为药物溶栓组（44例,采用静脉药物溶栓治疗）和CASI组（45例,采用CASI治疗）。对比两组疗效、术前住院时间、治疗后症状缓解时间、住院时间、左心室射血分数（LVEF）;随访患者1～3年,观察比较两组患者心脏事件（再闭塞、严重心衰、严重心律失常）和死亡的发生率。结果：CASI组再灌注成功率显著高于药物溶栓组（91.11%比68.18%）,P〈0.05。治疗后,与药物溶栓组比较,CASI组LVEF[（42.58±13.10）%比（57.32±18.61）%]显著升高,而症状缓解时间[（8.09±8.31）h比（3.75±3.58）h]和住院时间[（19.84±8.15）d比（13.01±5.40）d]显著缩短,P均〈0.01。随访期间,与药物溶栓组比较,CASI组严重心衰（18.18%比4.44%）、严重心律失常（22.73%比6.67%）发生率和死亡率（6.82%比2.22%）显著降低,P〈0.05或〈0.01。结论：冠状动脉腔内支架植入术治疗急性心肌梗死疗效显著,可显著缩短患者住院时间,且不良心脏事件发生率明显低于药物溶栓治疗,值得推广。Objective： To explore therapeutic effect of coronary artery stent implantation （CASI） on acute myocardial infarction （AMI）. Methods： According to voluntary choice, a total of 89 AMI patients were divided into drug thrombolysis group （n = 44, received intravenous drug thrombolytic therapy） and CASI group （n=45, received CA-SI treatment）. Therapeutic effect, symptom relieving time after treatment, hospitalization duration and left ventric- ular ejection fraction （LVEF） were compared between two groups; all patients were followed up for 1～3 years, in- cidence of death and cardiac events, including re- occlusion, severe heart failure and severe arrhythmias were ob- served and compared between two groups. Results： Success rate of reperfusion of CASI group was significantly high- er than that of drug thrombolysis group （91.11% vs. 68.18%）, P〈0.05. Compared with drug thrombolysis group, there were significant rise in LVEF [ （42.58 ± 13.10） % vs. （57.32 ± 18.61） %], and significant reductions in symp- tom relieving time [ （8.09±8. 31） h vs. （3.75 ± 3.58） hi and hospitalization duration [- （19.84 ± 8.15） d vs. （13.01 ± 5.40） d] in CASI group, P〈0.01 all. During follow - up, compared with drug thrombolysis group, there were significant reductions in incidence rates of severe heart failure （18.18% vs. 4.44%）, severe arrhythmias （22. 73% vs. 6. 67%） and death （6.82% vs. 2. 22%） in CASI group, P〈0.05 or 〈0.01. Conclusion： Coronary ar- tery stent implantation possesses significant therapeutic effect on acute myocardial infarction, it can significantly shorten hospitalization duration, and its incidence rate of adverse cardiac events is significantly lower than that of drug thrombolysis, which is worth extending.

关 键 词：心肌梗死 血管成形术 气囊 冠状动脉 血栓溶解疗法 

分 类 号：R542.22[医药卫生—心血管疾病]