冠状动脉血栓性病变早期和延迟介入治疗的疗效观察  

Impact of intracoronary thrombus on early outcome of primary and delay percutaneous coronary intervention

作　　者：胡健[1] 沈卫峰[1] 张建盛[1] 张瑞岩[1] 吕安康[1] 张宪[1] 郑爱芳[1] 

机构地区：[1]上海第二医科大学附属瑞金医院心脏科,200025

出　　处：《中华心血管病杂志》2004年第2期118-120,共3页Chinese Journal of Cardiology

摘　　要：目的　探讨冠状动脉内血栓形成对介入治疗早期疗效的影响。方法　自 1995年 10月至 2 0 0 2年 3月我院共对 115例有冠状动脉内血栓形成的患者进行了介入治疗 ,其中 4 8例即刻行冠状动脉介入治疗 (即刻治疗组 ) ,其他患者在肝素或溶栓治疗 7d后行介入治疗 (延迟治疗组 )。结果即刻治疗组和延迟治疗组的手术成功率相似 (91 7%比 97 1% ,P >0 0 5 ) ,但冠状动脉急性闭塞和严重心脏不良事件的发生例数即刻治疗组明显高于延迟治疗组 (3例比 0例和 2 7例比 16例 ,P值均 <0 0 5 )。结论　当冠状动脉内存在血栓形成时 ,在适时肝素治疗后行冠状动脉介入治疗可明显降低严重心脏不良事件的发生率。Objective To assess the impact of intracoronary thrombus on early outcome of percutaneous coronary intervention(PCI). Methods 115 patients received PCI between October 1995 and March 2002. PCI was performed immediately after coronary angiography in 48 patients (immediate PCI group) and after seven days of anticoagulant or thrombolytic therapy in the remaining 67 patients (delayed PCI group). Results The procedural successful rates between the two groups were similar (91.7% vs 97.1%, P>0.05). However the incidence of acute occlusion and major adverse cardiac events (MACE) in immediate PCI group was significantly higher than that in the delayed PCI group (3 vs 0 cases and 27 vs 16 cases, both P<0.05). Conclusion Immediate PCI may be not advised for thrombotic lesions because of increased risk of MACE.

关 键 词：冠状动脉血栓性病变 介入治疗 疗效观察 血栓溶解疗法 冠状动脉血栓形成 

分 类 号：R541.4[医药卫生—心血管疾病]