CAJ | 학술논문

目的：分析急性ST段抬高型心肌梗死（STEMI）患者直接经皮冠状动脉介入治疗（PCI）院内死亡原因。方法连续入选自首都医科大学附属北京潞河医院心内科2010年1月至2013年12月因STEMI行直接PCI院内死亡患者资料，回顾性分析其死亡原因。结果总计1314例STEMI患者进行直接PCI治疗，住院期间死亡44例，病死率3.3%；发病到就诊平均时间（5.3±4.6） h；43.8%的患者梗死相关血管为前降支，其中11例行经皮冠状动脉腔内成形术（PTCA），33例患者植入支架44枚，平均每例患者植入支架（1.1±0.8）枚。主要死亡原因为心源性休克56.8%，其次为心脏破裂占20.5%，15.9%死于血管并发症（包括无复流、支架内血栓、冠状动脉穿孔、夹层）。结论 STEMI患者直接PCI院内死亡原因依次为心源性休克、心脏破裂、血管并发症。
목적：분석급성ST단태고형심기경사（STEMI）환자직접경피관상동맥개입치료（PCI）원내사망원인。방법련속입선자수도의과대학부속북경로하의원심내과2010년1월지2013년12월인STEMI행직접PCI원내사망환자자료，회고성분석기사망원인。결과총계1314례STEMI환자진행직접PCI치료，주원기간사망44례，병사솔3.3%；발병도취진평균시간（5.3±4.6） h；43.8%적환자경사상관혈관위전강지，기중11례행경피관상동맥강내성형술（PTCA），33례환자식입지가44매，평균매례환자식입지가（1.1±0.8）매。주요사망원인위심원성휴극56.8%，기차위심장파렬점20.5%，15.9%사우혈관병발증（포괄무복류、지가내혈전、관상동맥천공、협층）。결론 STEMI환자직접PCI원내사망원인의차위심원성휴극、심장파렬、혈관병발증。
Objective To analyze the causes of in-hospital death during direct percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods The data were collected from died STEMI patients during PCI from Jan. 2010 to Dec. 2013, and the death causes were retrospectively analyzed. Results There were totally 1314 STEMI patients undergone PCI, among them 44 died during hospitalization and mortality was 3.3%, and average onset-to-hospital time was (5.3±4.6) h. There were 43.8%cases with anterior descending infarction, among them 11 undergone percutaneous transluminal coronary angioplasty. There were 33 cases undergone implantation of 44 stents and average (1.1±0.8) stents implanted in one case. The primary death causes were cardiogenic shock (56.8%), cardiac rupture (20.5%) and vascular complications (15.9%, including non-reflow, stent thrombosis, and coronary artery perforation and dissection). Conclusion The causes of in-hospital death during direct PCI are cardiogenic shock, cardiac rupture and vascular complications in STEMI patients.