非顺应性球囊后扩张在低血栓负荷的急性ST段抬高型心肌梗死合并2型糖尿病患者行急诊冠状动脉介入治疗的应用研究  

Clinical application of noncompliant balloon post-dilatation during emergency PCI in patients with acute ST-segment elevation myocardial infarction and type 2 diabetes mellitus with low thrombus burden

作　　者：郝荣 王大杰[1] 赵秋实[2] HAO Rong;WANG Da-jie;ZHAO Qiu-shi(Department of Cardiology,Third People′s Hospital of Yancheng City,Yancheng,Jiangsu,224005,China)

机构地区：[1]盐城市第三人民医院心内科,江苏盐城224005 [2]盐城市第三人民医院电生理室,江苏盐城224005

出　　处：《心血管康复医学杂志》2024年第1期84-89,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：2020年盐城市医学科技发展计划项目(YK2020069)。

摘　　要：目的:探讨使用非顺应性球囊行后扩张(post-dilatation,PD)治疗在低血栓负荷的急性ST段抬高型心肌梗死(ST-segment elevation acute myocardial infarction,STEMI)合并2型糖尿病(type 2 diabetes mellitus,T2DM)患者行急诊冠状动脉介入治疗(percutaneous coronary intervention,PCI)的临床疗效和安全性。方法:连续选取2016年1月至2021年12月因STEMI合并T2DM在我院行急诊PCI的患者122例,根据是否在PCI后行PD治疗分为PD组(n=78)及非PD组(n=44),比较两组的临床资料、手术情况、术后TIMI血流、术后ST段抬高指数回落(∑STIR)情况、住院期间主要心脏不良事件(MACE)的发生率以及PCI术后一年LVEF、支架内再狭窄和MACE发生率。结果:与非PD组相比,PD组住院期间MACE发生率(15.9%比3.8%)、PCI术后一年的支架内再狭窄(14.3%比2.6%)和MACE发生率(21.4%比2.6%)均显著降低(P<0.05或<0.01),而PCI术后一年的LVEF[58.50(52.75,65.25)%比64.00(58.25,67.50)%]显著升高(P=0.005)。结论:低血栓负荷的STEMI合并T2DM患者在急诊PCI中使用非顺应性球囊行PD治疗安全可行,且可降低住院期间MACE发生率、PCI术后一年的支架内再狭窄和MACE发生率,改善患者左心功能,为此类患者在急诊PCI治疗中使用PD治疗提供了临床参考。Objective:To explore the clinical therapeutic effect and safety of noncompliant balloon post-dilatation(PD)during emergency percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI)and type 2 diabetes mellitus(T2DM)with low thrombus burden.Methods:A total of 122 STEMI+T2DM patients,who underwent emergency PCI in our hospital from Jan 2016 to Dec 2021,were consecutively enrolled.According to PD therapy after PCI or not,they were divided into PD group(n=78)and non-PD group(n=44).Clinical data,PCI condition,postoperative TIMI blood flow,ST-segment elevation index resolution(∑STIR),incidence rate of the major adverse cardiac events(MACE)during hospital and LVEF,incidence rates of in-stent restenosis and MACE within one year after PCI were compared between two groups.Results:Compared with non-PD group,there were significant reductions in incidence rate of MACE during hospital(15.9%vs.3.8%),incidence rates of in-stent restenosis(14.3%vs.2.6%)and MACE within one year after PCI(21.4%vs.2.6%)in PD group(P<0.05 or<0.01),there were significant rise in LVEF within one year after PCI[58.50(52.75,65.25)%vs.64.00(58.25,67.50)%]in PD group(P=0.005).Conclusion:It's safe and feasible to apply noncompliant balloon PD during emergency PCI in STEMI+T2DM patients with low thrombus burden.It can reduce incidence rate of MACE during hospital,in-stent restenosis and MACE within one year after PCI,and improve left heart function of patients,and provide clinical reference for the use of PD therapy in emergency PCI for these patients.

关 键 词：心肌梗死 糖尿病 2型 血管成形术 气囊 冠状动脉 

分 类 号：R542.22[医药卫生—心血管疾病]