PCI术后近期胸痛原因分析

目的:探讨冠状动脉(冠脉)介入治疗术后近期胸痛的原因。方法:对比介入治疗后近期有胸痛的患者12例(胸痛组)与无胸痛患者100例(无胸痛组)的临床一般资料、心电图、心肌酶、术中小冠脉分支的损伤等情况。结果:胸痛组的12例中有10例心电图呈持续性ST-T改变,ST压低或(和)T波倒置。其中6例术中曾有冠脉小分支的闭塞并伴有心肌酶的升高,4例术中出现过夹层,2例出现冠脉内血栓和慢血流现象,与无胸痛组比较差别有统计学意义(P<0.01)。其余项目如年龄、性别、左室射血分数(LVEF)、吸烟、糖尿病、高血压、高脂血症、冠脉病变严重程度等2组间差别无统计学意义(P>0.05)。结论:胸痛的发生可能与术中冠脉小分支的闭塞性损伤导致小的局灶性心肌坏死,出现夹层,冠脉内血栓和慢血流现象有关。

Analysis the Causes of Chest Pain in the Early Stage after Percutaneous Coronary Intervention (PCI)

objective: To explore the possible causes of chest pain in the early stage after PCI. Methods: One hundred and twelve patients after PCI were divided into chest pain group (12 cases) and non chest pain group (100 cases). The general clinical characteristics, EKGs, cardiac enzymes, and the damages of small coronary artery branches in operation were compared between the two groups. Results: ST-T change, ST depress and T convert proved by EKG were observed in 10 patients of chest pain group. Among them, cardiac enzymes increased combined with small coronary artery branches obstructions in the operation in 6 patients, interlayers in the operation in 4 patients, and coronary thrombi and slow blood flow phenomena in 2 patients. There was a statistical significance compared with non chest pain group (P < 0.01). There was no statistical significance between the two groups on the other items (P > 0.05), such as age, sex, left ventricle eject fraction (LVEF), smoking, diabetes mellitus, hypertension, hyperlipaenda, and coronary damage degree. Conclusion: Chest pain may correlate with peri-interventional myocardial necrosis, interlayers, coronary thrombi and slow blood flow phenomena.