不同PCI术后支架植入时机对急性心肌梗死患者疗效及远期预后的影响  

Influences of different timing of stent implantation after PCI on curative effect and long-term prognosis of patients with acute myocardial infarction

作　　者：仇俊玲 马艳萍 QIU Junling;MA Yanping(the Fourth People's Hospital of Shaanxi,Xi'an 710043,China)

机构地区：[1]陕西省第四人民医院,陕西西安710043

出　　处：《临床医学研究与实践》2021年第27期54-56,共3页Clinical Research and Practice

摘　　要：目的比较不同经皮冠状动脉介入(PCI)术后支架植入时机对急性心肌梗死(AMI)患者疗效及远期预后的影响。方法根据急诊PCI术后支架植入时机的不同将240例AMI患者分为早期组(184例)和延迟组(56例)。早期组在急诊PCI术后即刻行支架植入术。延迟组在急诊PCI术后给予患者抗血小板治疗10~14 d,然后行支架植入术。比较两组的支架植入参数、临床疗效、心功能指标及远期预后。结果延迟组的支架植入长度短于早期组,支架植入数量少于早期组(P<0.05)。延迟组的MBGⅢ级率明显高于早期组,远端栓塞率和慢血流/无复流发生率明显低于早期组(P<0.05)。术后6个月,延迟组的LVEF和LVEDD明显优于早期组(P<0.05)。两组的MACE发生率及无MACE平均生存时间比较,差异无统计学意义(P>0.05)。结论与PCI术后即刻植入支架相比,支架延迟植入可优化支架植入参数,降低远端栓塞率和慢血流/无复流发生率,促进心功能恢复。Objective To compare the influences of different timing of stent implantation after percutaneous coronary intervention(PCI)on curative effect and long-term prognosis of patients with acute myocardial infarction(AMI).Methods A total of 240 patients with AMI were divided into early group(184 cases)and delayed group(56 cases)according to the timing of stent implantation after emergency PCI.Stent implantation was performed immediately after emergency PCI in the early group.The delayed group was treated with antiplatelet therapy for 10-14 d after emergency PCI,and then was given stent implantation.The stent implantation parameters,clinical efficacy,cardiac function indexes and long-term prognosis were compared between the two groups.Results The length of stent implantation in the delayed group was shorter than that in the early group,and the number of stent implantation was less than that in the early group(P<0.05).The rate of MBG with gradeⅢin the delayed group was significantly higher than that in the early group,and the distal embolization rate and the incidence of slow flow/no reflow were significantly lower than those in the early group(P<0.05).On 6 months after operation,LVEF and LVEDD in the delayed group were significantly better than those in the early group(P<0.05).There was no significant difference in the incidence of MACE and the MACE-free mean survival time between the two groups(P>0.05).Conclusion Compared with immediate stent implantation after PCI,delayed stent implantation can optimize stent implantation parameters,reduce the distal embolization rate and the incidence of slow blood flow/no reflow,and promote the recovery of cardiac function.

关 键 词：经皮冠状动脉介入术 支架植入时机 急性心肌梗死 远期预后 

分 类 号：R542.22[医药卫生—心血管疾病]