中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2012年
10期
813-816
,共4页
王乐丰%张大鹏%杨新春%徐立%葛永贵%王红石%李惟铭%倪祝华%夏昆%刘宇
王樂豐%張大鵬%楊新春%徐立%葛永貴%王紅石%李惟銘%倪祝華%夏昆%劉宇
왕악봉%장대붕%양신춘%서립%갈영귀%왕홍석%리유명%예축화%하곤%류우
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,percutaneous coronary%Treatment outcome
目的 探讨左主干急性病变所致急性心肌梗死急诊经皮冠状动脉介入治疗的效果.方法 入选1995年1月至2010年6月梗死相关动脉为左主干且行急诊经皮冠状动脉介入治疗的急性心肌梗死患者28例.根据住院期间是否死亡,将患者分为死亡组(10例)和存活组(18例).比较两组的临床特点,并对存活患者进行随访,观察主要不良心血管事件的发生情况.结果 25例患者置入支架；2例患者行经皮冠状动脉腔内成形术,术后10 d行冠状动脉旁路移植术；1例患者在介入操作过程中死亡.院内死亡共10例(35.7％)；合并心原性休克的15例患者院内死亡8例(53.3％).与存活组比较,死亡组入院时发生心原性休克的比例较高[80.0％(8/10)比38.9％ (7/18),P＜0.05],无侧支循环的比例也较高[100％ (10/10)比33.3％ (6/18),P＜0.01],介入治疗后前向血流心肌梗死溶栓试验(TIMI)3级的比例差异无统计学意义(P＞0.05).存活组患者住院时间为(22.1±2.6)d,术后3个月的累积生存率为64.3％.结论 急诊介入治疗左主干急性病变所致急性心肌梗死有较高的近期生存率；院内死亡者合并心原性休克和无侧支循环的比例较高.
目的 探討左主榦急性病變所緻急性心肌梗死急診經皮冠狀動脈介入治療的效果.方法 入選1995年1月至2010年6月梗死相關動脈為左主榦且行急診經皮冠狀動脈介入治療的急性心肌梗死患者28例.根據住院期間是否死亡,將患者分為死亡組(10例)和存活組(18例).比較兩組的臨床特點,併對存活患者進行隨訪,觀察主要不良心血管事件的髮生情況.結果 25例患者置入支架；2例患者行經皮冠狀動脈腔內成形術,術後10 d行冠狀動脈徬路移植術；1例患者在介入操作過程中死亡.院內死亡共10例(35.7％)；閤併心原性休剋的15例患者院內死亡8例(53.3％).與存活組比較,死亡組入院時髮生心原性休剋的比例較高[80.0％(8/10)比38.9％ (7/18),P＜0.05],無側支循環的比例也較高[100％ (10/10)比33.3％ (6/18),P＜0.01],介入治療後前嚮血流心肌梗死溶栓試驗(TIMI)3級的比例差異無統計學意義(P＞0.05).存活組患者住院時間為(22.1±2.6)d,術後3箇月的纍積生存率為64.3％.結論 急診介入治療左主榦急性病變所緻急性心肌梗死有較高的近期生存率；院內死亡者閤併心原性休剋和無側支循環的比例較高.
목적 탐토좌주간급성병변소치급성심기경사급진경피관상동맥개입치료적효과.방법 입선1995년1월지2010년6월경사상관동맥위좌주간차행급진경피관상동맥개입치료적급성심기경사환자28례.근거주원기간시부사망,장환자분위사망조(10례)화존활조(18례).비교량조적림상특점,병대존활환자진행수방,관찰주요불양심혈관사건적발생정황.결과 25례환자치입지가；2례환자행경피관상동맥강내성형술,술후10 d행관상동맥방로이식술；1례환자재개입조작과정중사망.원내사망공10례(35.7％)；합병심원성휴극적15례환자원내사망8례(53.3％).여존활조비교,사망조입원시발생심원성휴극적비례교고[80.0％(8/10)비38.9％ (7/18),P＜0.05],무측지순배적비례야교고[100％ (10/10)비33.3％ (6/18),P＜0.01],개입치료후전향혈류심기경사용전시험(TIMI)3급적비례차이무통계학의의(P＞0.05).존활조환자주원시간위(22.1±2.6)d,술후3개월적루적생존솔위64.3％.결론 급진개입치료좌주간급성병변소치급성심기경사유교고적근기생존솔；원내사망자합병심원성휴극화무측지순배적비례교고.
Objective To explore the clinical effect of primary percutaueous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) induced by left main artery total or subtotal occlusion.Methods Between January 1995 and June 2010,there were 28 AMI patients [24 males,mean age(61.5 ±2.3)years,15 patients complicated with cardiac shock] with left main occlusion or severe stenosis who were treated with PCI in our center.The clinical features were compared between death group and survival group.All survival cases were prospectively followed up for the occurrence of major adverse cardiac events.Results Totally 25 patients received stent implantation,2 received balloon dilation followed by coronary artery bypass graft,and 1 patient died during PCI.Total in-hospital mortality was 35.7 ％ (10/28),and mortality was 53.3％ (8/15) in cardiac shock patients.Compared with survival group,ratio of cardiac shock [80.0％ (8/10)vs.38.9％ (7/18),P ＜0.05] and poor collateral circulation flow [100％ (10/10)vs.33.3％ (6/18),P ＜0.01] were higher in death group,and there was no significant difference in TIMI 3 grade of forward flow post procedure (P ＞ 0.05).Hospital stay was (22.1 ± 2.6) days and the cumulative survival was 64.3％ during 3 months follow up for survival group.Conclusions Short-term clinical outcome is favorable for survived AMI patients with left main disease who underwent PCI.The ratio of cardiac shock and poor collateral circulation flow are risk factors for in-hospital death in AMI patients with left main disease who underwent PCI.
