血管内超声应用于急性心肌梗死患者 经皮冠状动脉介入术中的效果观察  

Effect of intravascular ultrasound in percutaneous coronary intervention for patients with acute myocardial infarction

作　　者：倪挺[1] 刘敏 王振磊 许群锋 王明亮[1] Ni Ting;Liu Min;Wang Zhenlei;Xu Qunfeng;Wang Mingliang(Department of Cardiovascular Medicine,Putuo District People′s Hospital,Shanghai 200060,China)

机构地区：[1]上海市普陀区人民医院心血管内科,200060

出　　处：《中国药物与临床》2021年第2期228-231,共4页Chinese Remedies & Clinics

摘　　要：目的探讨急诊冠状动脉介入在急性心肌梗死患者中的应用及冠状动脉血管内超声预后评估价值。方法将2016年1月至2018年12月收治急性心肌梗死患者150例,根据检查方法不同分为2组,对照组行冠状动脉造影检查,研究组行冠状动脉血管超声检查,2组患者分别做完检查后,行急诊冠状动脉介入治疗。比较2组首次球囊扩张后急性获益、斑块负荷、支架最小横截面积、支架最小直径等情况,比较2组术后急性获益、斑块负荷、支架最小横截面积等情况及术后住院期、出院后1个月、出院后3个月、出院后半年发生心脏不良事件的例数。结果研究组急性获益、支架最小横截面积、支架最小直径均大于对照组,斑块负荷小于对照组(P<0.05);2组介入术后斑块负荷、支架最小横截面积对比差异无统计学意义(P>0.05),但研究组介入术后急性获益大于对照组(P<0.05);2组术后住院期对比,不良反应发生率差异无统计学意义(P>0.05),但研究组出院后1个月、3个月、半年的不良事件发生率低于对照组(P<0.05)。结论急诊冠状动脉介入治疗急性心肌梗死患者中应用冠状动脉血管内超声检查,能够降术后心脏不良事件的发生率,降低术后冠状动脉支架内在狭窄的发生率,改善患者预后,可有效保证急诊冠状动脉介入治疗的安全性,值得临床推广应用。Objective To determine the use of emergency coronary intervention in the patients with acute myocardial infarction and the evaluation on prognosis of coronary intravascular ultrasound.Methods A total of 150 patients with acute myocardial infarction admitted to our hospital between January 2016 and December 2018 were divided into two groups according to different examination methods.The control group underwent coronary angiography and the study group underwent coronary vascular ultrasound examination.Both groups underwent emergency coronary intervention after the examination,respectively.The acute benefit,plaque load,minimum stent cross-sectional area,and minimum stent diameter after the first balloon dilation were compared between the two groups.The postoperative acute benefit,plaque load,minimum stent cross-sectional area,and the number of patients with adverse cardiac events during postoperative hospital stay,and at 1,3 and 6 months after discharged home.Results The acute benefit,minimum cross-sectional area and minimum diameter of the stent in the study group were all greater than those in the control group,whereas the plaque load was less than that in the control group(all P<0.05).There was no significant difference in plaque load and minimum cross-sectional area between the two groups after the intervention(both P>0.05),but the acute benefit in the intervention group after the intervention was greater than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups after postoperative hospital stay(P>0.05).The incidence of adverse events in the study group was lower than that in the control group at 1,3 and 6 months after discharged home,respectively(P<0.05).Conclusion Using coronary intravascular ultrasound in emergency coronary intervention in patients with acute myocardial infarction may reduce the incidence of postoperative cardiac adverse events,decrease the incidence of postoperative coronary in-stent stenosis,improve the prognosis

关 键 词：冠状动脉血管内超声检查 不良事件 心肌梗死 经皮冠状动脉介入疗法 冠状动脉血管造影 

分 类 号：R542.22[医药卫生—心血管疾病]