介入相关性心肌梗死与预后的关系  

Prognostic Significance of Procedure-related Myocardial Infarction:A Retrospective Study

作　　者：王彦涵 耿金[1] 魏忠海 戴庆[1] 王涟[1] 宋杰[1] 

机构地区：[1]南京医科大学鼓楼临床医学院心血管内科,210008

出　　处：《医学研究杂志》2017年第10期88-92,共5页Journal of Medical Research

基　　金：江苏省卫生厅基金资助项目(H201436)

摘　　要：目的研究经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后发生介入相关性心肌梗死对预后的影响。方法选择行PCI术治疗的患者共360例,根据是否发生介入相关性心肌梗死分为心肌梗死组及非心肌梗死组,观察术后6个月超声心动图较术前相比左心室射血分数变化量(△LVEF)以及随访过程中主要不良心血管事件(the major adverse cardiovascular events,MACE)发生率。结果△LVEF心肌梗死组与非心肌梗死组比较差异有统计学意义(P=0.002);MACE发生率心肌梗死组与非心肌梗死组比较差异有统计学意义(P=0.004);分层分析示,对于非旋磨患者,介入相关性心肌梗死与△LVEF(P=0.000)及MACE(P=0.004)相关,在旋磨患者中,介入相关性心肌梗死与△LVEF(P=0.857)及MACE(P=0.241)未见同样的相关性。结论介入相关性心肌梗死对于非旋磨的患者发生左心室射血分数下降、MACE发生具有预测价值,在旋磨患者中则并未显示相应的预测性。Objective To study the prognostic relevance of procedure- related myocardial infarction（PMI） in patients experienced percutaneous coronary intervention（PCI）. Methods A total of 360 patients experienced PCI treatment were divided into myocardial in- farction（MI） group and non- M I group on the basis of occurrence of PMI. The change in left ventricular ejection fraction （A LVEF） 6 months after PCI and the follow -up period major adverse cardiovascular events（MACE） rates were collected. Results There were sta- tistical significant differences between the two groups on A LVEF （P = 0. 002） and occurrence rate of MACE （P = O. 004） ; Stratified a- nalysis showed PMI was related to A LVEF （P = 0. 000） and occurrence rate of MACE （P = 0. 004） in patients without percutaneous cor- onary rotational atherectomy（PTCRA）, but in patients experienced PTCRA, PMI didn＇t show the same relevance to ALVEF （P = 0. 857 ） and MACE （P = 0. 241 ）. Conclusion PMI is indicated prognostic value of A LVEF and occurrence rate of MACE in non - PT- CRA patients, and corresponding association is not found in PTCRA parients.

关 键 词：经皮冠状动脉介入治疗 经皮冠状动脉内旋磨术 介入相关性心肌梗死 

分 类 号：R543.3[医药卫生—心血管疾病]