经皮冠状动脉介入治疗左主干病变所致的急性心肌梗死临床分析  

Clinical Analysis of PCI for Treating the Patients of Acute Myocardial Infarction Caused by Left Main Coronary Artery Lesions

作　　者：王建锋[1,2] 周国伟[1] 张国兵[1] 李为真[1] 刘少稳[1] 

机构地区：[1]上海市第一人民医院心内科,200080 [2]江苏省南通市通州区人民医院心内科,226300

出　　处：《中国循环杂志》2016年第10期962-965,共4页Chinese Circulation Journal

摘　　要：目的:探讨左主干病变导致急性心肌梗死(AMI)的临床表现及其经皮冠状动脉介入治疗(PCI)的疗效。方法:我院2000-01至2015-12期间共有3 514例诊断为AMI患者进行了冠状动脉造影(CAG),其中发生的梗死相关动脉(IRA)为左主干的患者36例。36例左主干病变所致的AMI患者中,28例进行了PCI,8例进行了冠状动脉旁路移植术(CABG)。对这28例进行了PCI患者的临床表现及疾病转归进行回顾性分析。结果:左主干病变所致的AMI且进行了PCI的28例患者中,女性5例,男性23例,平均年龄(66.5±8.32)岁。16例为ST段抬高型心肌梗死(STEMI),12例为非ST段抬高型心肌梗死(NSTEMI)。21例为急诊PCI,7例为择期PCI。入院时表现心原性休克为16例,手术成功率为82.1%,院内病死率为35.7%(10/28)。长期随访(66.1±35.2)个月,有3例患者发生再次NSTEMI,1例进行了再次PCI,3例患者死亡,存活者无事件生存率为66.7%。结论:左主干病变所致的AMI进行PCI是可行的,院内生存率为64.3%,存活者长期随访的严重不良事件仍较高。Objective：To explore clinical features of acute myocardial infarction（AMI） caused by left main（LM） coronary artery lesions and to study the effect of percutaneous coronary intervention（PCI） in relevant patients.Methods：A total of 3514 AMI patients received coronary angiography（CAG） in our hospital from 2000-01 to 2015-12 were studied,those including 36 of infarct-related artery（IRA） as LM.There were 28/36 patients received PCI and 8 received CABG.The clinical features and outcomes in 28 LM disease patients were investigated.Results：The patients included 5 female and 23 male at the mean age of（66.5±8.32） years.There were 16 patients with ST-segment elevation myocardial infarction（STEMI） and 12 with NSTEMI;21 received primary PCI and 7 had elective PCI;there were 16 patients suffered from cardiac shock at admission.The procedural success rate was 82.1% and the in-hospital mortality was 35.7%（10/28）.During（66.1±35.2） months follow-up period,3 patients had re-NSTEMI and 1 of them received PCI again,3 patients died.No event survival rate was 66.7%.Conclusion：PCI is feasible for treating AMI patients caused by LM lesions,the in-hospital survival rate was 64.3%;while the MACE occurrence rate during long-term follow-up period has been high.

关 键 词：血管成形术 经腔 经皮冠状动脉 心肌梗死 

分 类 号：R54[医药卫生—心血管疾病]