延迟经皮冠状动脉介入术治疗急性心肌梗死的疗效观察  

Delayed percutaneous coronary intervention in patients with acute myocardial infarction

作　　者：吕蓓[1] 陆国平[1] 沈卫峰[1] 

机构地区：[1]上海第二医科大学瑞金医院心内科,上海200025

出　　处：《临床心血管病杂志》2003年第10期579-580,共2页Journal of Clinical Cardiology

摘　　要：目的 :评价急性心肌梗死 (AMI)患者起病 1个月内行延迟经皮冠状动脉介入 (PCI)术的疗效。方法 :回顾性分析 2 12例首次AMI患者中 14 6例行延迟PCI术 (执行时间中位数 :发病后 15 .8d)与 6 6例未行延迟PCI术患者住院期死亡和起病 1年内死亡、再次AMI和死亡或 (和 )再次AMI的发生率。结果 :行延迟PCI术的患者与未行延迟PCI的患者相比 ,其住院期死亡 (2 .1%∶2 4 .0 % ,P <0 .0 1)、起病 1年内死亡 (2 .7%∶9.1% ,P <0 .0 1)、再次AMI(2 .1%∶6 .1% ,P <0 .0 5 )和死亡或 (和 )再次AMI(3.4 %∶13.6 % ,P <0 .0 1)的发生率均显著降低。多因素分析显示PCI术能独立降低AMI患者住院期死亡率 (OR 0 .0 2 8,95 %CI 0 .0 8～ 0 .112 )和 1年内死亡或 (和 )再次AMI的发生率 (OR 0 .191,95 %CI 0 .0 6～ 0 .6 0 8)。结论 :AMI后Objective:To assess the effect of delayed percutaneous coronary intervention(PCI) during 30 days after acute myocardial infarction (AMI). Methods:Two hundred and twelve patients with AMI were divided into two groups, 146 cases treated with delayed PCI (performed median of 15.8 days), and 66 cases treated without delayed PCI. In hospital and one year end point events including cardiac death, recurrent AMI, cardiac death and recurrent AMI were compared between two groups retrospectively. Results:AMI patients treated with delayed PCI had lower in hospital mortality ( 2.1 % vs 24.0 %, P< 0.01 ), lower one year incidence of death ( 2.7 % vs 9.1 %, P< 0.01 ) as well as recurrent AMI ( 2.1 % vs 6.1 %, P< 0.05 ) and lower one year combined incidence of death and recurrent AMI ( 3.4 % vs 13.6 %, P< 0.01 ) than those treated without delayed AMI. In a multivariate model the adjusted odds ratio for in hospital mortality and for one year combined incidence of death and recurrent AMI were 0.028 and 0.191 respectively. Conclusion:The delayed PCI during 30 days of AMI is associated with better outcomes.

关 键 词：心肌梗死 经皮冠状动脉介入治疗 

分 类 号：R542.2[医药卫生—心血管疾病]