急性心肌梗死后延迟冠状动脉内支架置入疗效及并发症分析

目的　探讨急性心肌梗死 (AMI)溶栓后延迟病变冠状动脉支架置入疗效及并发症。方法　 AMI病例 16 0例 ,分为静脉溶栓再通 (A )组和静脉溶栓未通 (B)组 ,于 AMI后 3～ 15日行冠状动脉内支架置入治疗 ,随访 6个月 ,均于随访前后查超声心动图 (UCG) ,测定左心室射血分数 (L VEF)。结果　 A、B两组均有很高比例的梗死相关血管(IRA)和一定比例的非梗死相关血管 (non- IRA)残留严重狭窄。IRA狭窄程度 B组比 A组严重 (P<0 .0 5 )。成功置入支架 15 2例 (95 % ) ,A、B两组间手术成功率和严重并发症发生率无显著性差异。 138例 (90 .7% )随访 6个月 ,随访期内无死亡病例。与 B组比较 ,A组心血管事件发生率低 (P<0 .0 5 ) ,A组随访期间 L VEF较随访前增加 (P<0 .0 5 ) ,较 B组高 (P<0 .0 5 )。结论　 AMI病例溶栓后存在严重的 IRA和 non- IRA残留狭窄 ,行冠状动脉内支架置入是必要的、安全的 ,手术成功率高 ,可改善患者预后

Analysis of effect and complication in delaying coronary stenting after acute myocardial infarction

Objective To evaluate the effect and complication of coronary stenting after acute myocardial infarction (AMI). Methods 160 AMI patients with re-emerging myocardial ischemia underwent stenting trentment in 3-15 days after AMI. They were divided into intravenous thrombolytic patency group (group A),non-patency group (group B).Follow-up was 6 months. Left ventricular ejection fraction(LVEF) was measured by ultrasonic cardiogram (UCG) before and after follow-up. Results Both group A and group B had a large proportion of IRA and some non-IRA serious residual stenosis, and degree of stenosis was higher in group B than in group A(P< 0.05). 152 cases (95%) were successfully stenting , and successful rate of stenting and occurring rate of serious complications hadn't significant difference. 138 cases (90.7%) were follow-up in 6 months and there was no death. The occurring rate of cardiovascular incident was lower in group A than in group B(P<0.05). LVEF in group A was higher at the end of follow-up than before follow-up and in group B(P<0.05).Conclusion It is necessary, safety and higher successful rate to stent for serious stenosis IRA and non-IRA of re-emerging myocardial ischemic cases after AMI. It can improve prognosis of patients. Thrombocytic patency cases can make more profit on it.