经皮冠状动脉介入治疗急性ST段抬高型心肌梗死与急性非ST段抬高型心肌梗死患者的临床对比  

Clinical comparative analysis and significance of patients undergoing percutaneous coronary intervention for ST-elevation type and non-ST-elevation type of aute myocardial infarction

作　　者：杨体霞[1] 程昭栋[1] 李峰[1] 沈童童[1] 刘亚圆[1] 王欣欣[1] 王甜 Yang Tixia;Cheng Zhaodong;Li Feng;Shen Tongtong;Liu Yayuan;Wang Xinxin;Wang Tian(Department of Cardiology,Chuzhou Hospital Affiliated to Anhui Medical University,Chuzhou 239000,China)

机构地区：[1]安徽医科大学附属滁州医院心血管内科,滁州239000

出　　处：《中国临床保健杂志》2023年第4期535-539,共5页Chinese Journal of Clinical Healthcare

基　　金：安徽省滁州市卫生健康科研项目(2022009)。

摘　　要：目的对比经皮冠状动脉介入治疗中的急性ST段抬高型心肌梗死(STEMI)与急性非ST段抬高型心肌梗死(NSTEMI)患者在住院期间临床特征、介入诊疗以及预后方面的差异。方法回顾性分析同期住院的经皮冠状动脉介入治疗的152例急性心肌梗死患者,根据ST段是否抬高分为STEMI组(98例)及NSTEMI组(54例)。统计2组患者的临床资料、冠脉造影及介入治疗结果,随访1年内有无再次经皮冠状动脉介入治疗,以及有无死亡情况,对比2组相关临床资料,分析STEMI与NSTEMI患者住院期间临床特征、冠脉介入及预后等方面的差异。结果2组患者在男女比例、高血压病、高脂血症以及糖尿病患病率方面,差异均无统计学意义(P>0.05);NSTEMI组患者年龄较STEMI患者偏大,差异有统计学意义(P<0.05);NSTEMI组合并肾功能不全的患者比例较STEMI组高(P<0.05);在抽烟这一危险因素方面,STEMI组患者比例高于NSTEMI组,差异有统计学意义(P<0.05);STEMI组患者行急诊经皮冠状动脉介入治疗(PCI)的比例明显高于NSTEMI组(P<0.05),在行PCI过程中,需要辅助治疗(血栓抽吸、主动脉球囊反搏、临时起搏或电除颤)的患者比例,STEMI组高于NSTEMI组(P<0.05),冠状动脉造影过程中我们发现NSTEMI组三支病变的发生率远高于STEMI组(P<0.05),而侧支循环的形成在NSTEMI组中也较STEMI组常见,差异有统计学意义(P<0.05)。在1年的随访中发现,NSTEMI组再次行PCI的比例较STEMI组高,差异有统计学意义(P<0.05)。住院期间2组患者在住院时间和住院费用方面差异无统计学意义(P>0.05),2组患者在院内心力衰竭及院内死亡的发生率上差异也无统计学意义(P>0.05),在1年随访时发现,2组患者发生死亡的比例差异也无统计学意义(P>0.05)。结论接受PCI术治疗的STEMI及NSTEMI患者虽然临床情况及冠脉介入诊疗方面有所不同,但近期及1年后的临床预后相似。Objective To compare the differences in clinical characteristics,interventional treatment,and prognosis between STEMI and NSTEMI patients undergoing percutaneous coronary intervention during hospitalization.Methods One hundred and fifty-two hospitalized patients with acute myocardial infarction undergoing percutaneous coronary intervention,and they were divided into STEMI group(n=98)and NSTEMI group(n=54)according to electrocardiographic findings.Clinical data of the two groups was retrospectively analyzed,including clinical information,coronary angiography,and interventional treatment results.Patients of the two groups were followed up for one year,the second PCI treatment and death was recorded and analyzed.The relevant clinical data between the two groups was compared,and the differences in clinical characteristics,coronary intervention,and prognosis between STEMI and NSTEMI patients analyzed during hospitalization.Results There was no statistical difference between the two groups in terms of male female ratio,hypertension,hyperlipidemia and prevalence of diabetes(P>0.05).Patients in the NSTEMI group were older than those in the STEMI group,with a statistically significant difference(P<0.05).The proportion of patients with renal insufficiency in the NSTEMI group was higher than that in the STEMI group(P<0.05).In terms of smoking as a risk factor,the proportion of patients in the STEMI group was higher than that in the NSTEMI group,with a statistically significant difference(P<0.05).The proportion of patients in the STEMI group undergoing emergency PCI was significantly higher than that in the NSTEMI group(P<0.05).During PCI,the proportion of patients requiring adjuvant treatment(thrombus aspiration,IABP,temporary pacing,or electrical defibrillation)was higher in the STEMI group than in the NSTEMI group(P<0.05).We found that the incidence of three vessel lesions in the NSTEMI group was significantly higher than that in the STEMI group(P<0.05),and the formation of collateral circulation was also more common in t

关 键 词：心肌梗死 ST段抬高型心肌梗死 非ST段抬高型心肌梗死 经皮冠状动脉介入治疗 预后 

分 类 号：R542.22[医药卫生—心血管疾病]