中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2008年
6期
485-488
,共4页
马礼坤%余华%冯克福%施有为%张晓红%戴小华%高潮%唐宝龙%程志祥%陈鸿武%夏铭蔚%韩晓萍%叶琪%严激
馬禮坤%餘華%馮剋福%施有為%張曉紅%戴小華%高潮%唐寶龍%程誌祥%陳鴻武%夏銘蔚%韓曉萍%葉琪%嚴激
마례곤%여화%풍극복%시유위%장효홍%대소화%고조%당보룡%정지상%진홍무%하명위%한효평%협기%엄격
心肌梗死%血管成形术,经腔,经皮冠状动脉%治疗结果
心肌梗死%血管成形術,經腔,經皮冠狀動脈%治療結果
심기경사%혈관성형술,경강,경피관상동맥%치료결과
Myocardial infarction%Angioplasty,transluminal,pcrcutaneous coronary%Treatment outcome
目的 探讨急性心肌梗死(AMI)后不同时间转运行直接急诊经皮冠状动脉介入治疗(PCI)的安全性和临床疗效.方法 因ST段抬高性的AMI收住外院,并转运至我院行急诊直接PCI的患者,按照发病至开始转诊的时间分为早期转运组(<6 h)、延迟转运组(6～24 h)和晚期转运组(24 h～1周).观察各组转运安全性、急诊PCI术成功率和1个月随访期间左室功能及临床疗效.结果 83例AMI经急诊转入我院接受PCI患者中,早期转运26例,延迟转运39例,晚期转运18例.转运过程中除早期转运和延迟转运组各有2例(分别占7.7%和5.1%)发生心绞痛症状外,各组均无死亡、心力衰竭、心原性休克、室性心动过速和心室颤动等严重心脏事件发生.所有患者均接受了急诊直接PCI术,各组开始转运至球囊扩张时间均在180 min左右.早期转运组PCI成功率为92.3%,延迟转运组为89.7%,晚期转运组为94.4%,各组间比较差异无统计学意义.PCI术后1个月内随访,早期转运组无心脏事件发生;延迟转运组4例(10.3%)发生失代偿性心力衰竭,其中1例(2.6%)在1个月内因心力衰竭死亡;晚期转运组3例(16.7%)发生失代偿心力衰竭,治疗好转出院.3～4周超声心动图示早期转运组左室射血分数为53.2%±9.7%,明显高于延迟转运(48.6%±8.2%,P<0.05)和晚期转运组(43.1%±10.3%,P<0.01).结论 AMI后不同时间对经选择的患者采取转运直接PCI是安全的,且早期转运PCI的疗效明显优于延迟或晚期转运的患者.
目的 探討急性心肌梗死(AMI)後不同時間轉運行直接急診經皮冠狀動脈介入治療(PCI)的安全性和臨床療效.方法 因ST段抬高性的AMI收住外院,併轉運至我院行急診直接PCI的患者,按照髮病至開始轉診的時間分為早期轉運組(<6 h)、延遲轉運組(6～24 h)和晚期轉運組(24 h～1週).觀察各組轉運安全性、急診PCI術成功率和1箇月隨訪期間左室功能及臨床療效.結果 83例AMI經急診轉入我院接受PCI患者中,早期轉運26例,延遲轉運39例,晚期轉運18例.轉運過程中除早期轉運和延遲轉運組各有2例(分彆佔7.7%和5.1%)髮生心絞痛癥狀外,各組均無死亡、心力衰竭、心原性休剋、室性心動過速和心室顫動等嚴重心髒事件髮生.所有患者均接受瞭急診直接PCI術,各組開始轉運至毬囊擴張時間均在180 min左右.早期轉運組PCI成功率為92.3%,延遲轉運組為89.7%,晚期轉運組為94.4%,各組間比較差異無統計學意義.PCI術後1箇月內隨訪,早期轉運組無心髒事件髮生;延遲轉運組4例(10.3%)髮生失代償性心力衰竭,其中1例(2.6%)在1箇月內因心力衰竭死亡;晚期轉運組3例(16.7%)髮生失代償心力衰竭,治療好轉齣院.3～4週超聲心動圖示早期轉運組左室射血分數為53.2%±9.7%,明顯高于延遲轉運(48.6%±8.2%,P<0.05)和晚期轉運組(43.1%±10.3%,P<0.01).結論 AMI後不同時間對經選擇的患者採取轉運直接PCI是安全的,且早期轉運PCI的療效明顯優于延遲或晚期轉運的患者.
목적 탐토급성심기경사(AMI)후불동시간전운행직접급진경피관상동맥개입치료(PCI)적안전성화림상료효.방법 인ST단태고성적AMI수주외원,병전운지아원행급진직접PCI적환자,안조발병지개시전진적시간분위조기전운조(<6 h)、연지전운조(6～24 h)화만기전운조(24 h～1주).관찰각조전운안전성、급진PCI술성공솔화1개월수방기간좌실공능급림상료효.결과 83례AMI경급진전입아원접수PCI환자중,조기전운26례,연지전운39례,만기전운18례.전운과정중제조기전운화연지전운조각유2례(분별점7.7%화5.1%)발생심교통증상외,각조균무사망、심력쇠갈、심원성휴극、실성심동과속화심실전동등엄중심장사건발생.소유환자균접수료급진직접PCI술,각조개시전운지구낭확장시간균재180 min좌우.조기전운조PCI성공솔위92.3%,연지전운조위89.7%,만기전운조위94.4%,각조간비교차이무통계학의의.PCI술후1개월내수방,조기전운조무심장사건발생;연지전운조4례(10.3%)발생실대상성심력쇠갈,기중1례(2.6%)재1개월내인심력쇠갈사망;만기전운조3례(16.7%)발생실대상심력쇠갈,치료호전출원.3～4주초성심동도시조기전운조좌실사혈분수위53.2%±9.7%,명현고우연지전운(48.6%±8.2%,P<0.05)화만기전운조(43.1%±10.3%,P<0.01).결론 AMI후불동시간대경선택적환자채취전운직접PCI시안전적,차조기전운PCI적료효명현우우연지혹만기전운적환자.
Objective To evaluate the safety and outcome of patients with acute myocardial infarction (AMI) transferred for primary percutanous coronary intervention (PCI).Methods Data from patients with ST elevation AMI urgently transferred from first admitted hospitals to our catll-lab to receive primary PCI were analyzed.According to time intervals from symptom onset to transfer.the patients were divided into early transfer(<6 h,n=26),delayed transfer (6-24h,n=39) and late transfer (24 h to 1 week,n=18) group.The major cardiac events during transfer periods and one month after PCI were obtained and echocardiogram and left ventficular systolic functions were compared among groups.Results There was no serious cardiac event during transfer period and all 83 patients received primary PCI with a mean transfer-to-balloon time about 180 minutes.Success rate of PCI was 92.3% in early transfer group.89.7% in delayed transfer group,and 94.4% in late transfer group (P>0.05).At one month follow-up after PCI.0.10.3%and 16.7% of patients developed heart failure in early,delayed transfer and late transfer group respectively (P>0.05 vs.early),the LVEF of early transfer group (53.2%±9.7%) was also significantly higher than delayed transfer group (48.6%±8.2%,P<0.05) and late transfer group (43.1%±10.3%,P<0.01).Conclusions Transfer patients with AMI for primary PCI iS safe in the observed time intervals during acute phase.Early transferred patients are associated with better outcome at 1 month post PCI compared to delayed and late transferred AMI patients.
