多支血管病变急性心肌梗死患者行经皮冠状动脉介入术治疗策略对比分析  

Comparative analysis of PCI treatment strategies in patients with acute myocardial infarction and multivessel disease

作　　者：陈浩[1] 黄艺生 林建生 罗助荣[1] Chen Hao;Huang Yisheng;Lin Jiansheng;Luo Zhurong(Department of Cardiology, the PLA'900th Hospital, Fuzhou 350000, China;Medical Image Center, The PLA'900th Hospital, Fuzhou 350000, China;Department of Radiology, Anxi County Hospital of Fujian Province, Quanzhou 362400, Fujian, China)

机构地区：[1]中国人民解放军联勤保障部队第900医院心血管内科,福州350000 [2]中国人民解放军联勤保障部队第900医院医学影像中心,福州350000 [3]福建省泉州市安溪县医院放射科,福建泉州362400

出　　处：《血管与腔内血管外科杂志》2018年第5期418-422,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的观察比较急性心肌梗死(AMI)多支血管病变急诊经皮冠状动脉介入治疗(PCI)对非梗死相关血管处理的策略变化对心血管预后终点事件的影响。方法选择解放军福州总医院2010年1月至2018年1月收治的发生AMI并成功进行罪犯血管PCI治疗的800例患者为研究对象,PCI时进行完全再血管化为A组共158例,住院期间分次完成为B组共325例,出院后再分次完成为C组共241例,罪犯血管再血管化为D组共76例,对比分析四组非罪犯血管采取不同手术策略后平均12个月内的随访结果。结果 A组、B组、C组患者(心绞痛、各种心律失常、心功能衰竭、心源性死亡、心肌梗死和再次血运重建术)入院率均明显低于D组(P<0.05)。但A组、B组、C组两两比较差异均无统计学意义(P>0.05)。结论完全的再血管化策略能降低紧急再血管化风险,并与较低的主要心血管不良事件(MACE)事件有关。但仍需要进一步的试验明确完全再血管化各种策略对心血管相关风险的影响。Objective To observe the effect of simultaneous intervention of non-infarct related artery(non-IRA) in patients with acute elevation myocardial infarction(AMI) and multivessel disease. Methods Choose the people’s liberation army of fuzhou general hospital between January 2010 and January 2018 in AMI and successful criminal PCI treatment of 800 patients as the research object, the PCI full blood vessels into A total of 158 cases of group A, hospitalization time for A total of 325 cases of group B, after discharge to divide time for A total of 241 cases of group C, the criminal blood vessels and 76 cases of blood vessels into group D, analysis of four groups of criminals vessels take different surgical strategies an aerage follow-up of 12 months after the results. Results In group A and group B, C groups of patients(angina pectoris, arrhythmia, heart failure, cardiac death, myocardial infarction, and again blood supply revascularization) admission rate were significantly lower than that of group D(P<0.05). But in group A, group B and group C comparing two differences had no statistical significance(P>0.05). Conclusion Complete vascularized strategy can reduce the risk of emergent vascularized, which is associated with lower MACE. However, further experiments will be needed to demonstrate the effects of various strategies of vascularized on cardiovascularrelated risks.

关 键 词：急性心肌梗死 经皮冠状动脉介入术 多支血管病变 罪犯血管 非罪犯血管 

分 类 号：R543.1[医药卫生—心血管疾病]