慢性冠状动脉闭塞病变与急性ST段抬高心肌梗死经皮冠状动脉介入治疗的对照研究

目的比较慢性冠状动脉闭塞病变（CTO）与急性ST段抬高心肌梗死（ASTEMI）经皮冠状动脉介入治疗（PCI）前后疗效。方法59例冠心病患者,根据WHO标准分成慢性冠状动脉闭塞病变组30例和急性ST段抬高心肌梗死组29例。行冠状动脉支架置入,术后对梗死相关动脉TIMI血流、心电图、心功能、心肌损伤标志物等资料进行统计对比分析。结果PCI对慢性冠状动脉闭塞病变梗死相关动脉TIMI血流提高到3级可达93.33%,但对心电图ST-T改变、心肌损伤标志物的峰值和达峰时间、心功能（EF值）、左室收缩末期内径（LVESD）和舒张末期内径（LVEDD）以及短轴缩短率（FS）均无影响（P〉0.05）。而PCI对ASTEMI手术前后的梗死相关动脉TIMI血流3级、心电图ST-T回落、心肌损伤标志物术后峰值、心功能均有统计学意义（P〈0.05）。结论PCI对急性ST段抬高心肌梗死的临床益处已被公认,但对慢性冠状动脉闭塞病变的临床效果有待进一步观察。

Control study in percutaneous coronary intervention for chronic total coronary occlusion and acute ST-segment elevated myocardial infarction

Objective To compare the clinical outcomes of percutaneous coronary intervention（PCI）for chronic total coronary occlusion（CTO）and acute ST-segment elevated myocardial infarction（ASTEMI）.Methods The data of 59 patients were processed coronany angiography.All the cases were divided into CTO group（n=30）and ASTEMI group（n=29） according to the standard of WHO.To analyses the correlated data after stent implanted.Results The blood stream get to TIMI 3 grade were 93.33%,but the electrocardiogram,myocardial injury marker,heart function were without change in CTO（P0.05）.The blood stream get to TIMI 3 grade,the electrocardiogram,myocardial injury marker,heart function were all significant in ASTEMI（P0.05）.Conclusion The advantage of PCI in ASTEMI is accepted,but the clinical effect in CTO still needs discussion.