非ST段抬高急性冠状动脉综合征患者的介入治疗

目的：分析急性冠脉综合征患者非ST段抬高时行经皮冠状动脉介入治疗术(PCI)的有效性和安全性。方法：从2001年1月至2003年10月在我院住院的72例非ST段抬高急性冠脉综合征病人，包括不稳定型心绞痛病人UAP)48例，非ST抬高急性心肌梗死(NSTEMI)病人24例，除常规内科治疗外，接受冠状动脉造影及介入治疗(PTCA和支架植入术)。造影提示单支血管病变31例(43．1％)，双支血管病变25例(34．7％)，三支血管病变16例(22．2％)，分别行PTCA和支架植入术。结果：介入治疗的成功率97．2％(70／72)，失败的两例患者主要是导丝不能通过闭塞病变所致。在70例患者中，共植入支架91枚。随访至术后30d，无症状或症状明显缓解的61例；2例发生ST段抬高急性心肌梗死；4例多支血管病变患者再次行介入治疗；3例患者转外科行CABG术；2例患者死亡。结论：经皮冠状动脉介入治疗是非ST段抬高急性冠脉综合征的有效和安全的治疗方法。

The clinical analysis of percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndrome

Objective To evaluate the safety and efficacy of percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndrome. Methods From Jan. 2001 to Oct. 2003,72 patients with non-ST-segment elevation acute coronary syndrome, including 48 cases with unstable angina pectoris(UAP),24 cases with non-ST-segment elevation myocardial infarction (NSTEMI), were underwent coronary angiography and percutaneous coronary intervention(PTCA and Stenting) in our hospital.Coronary angiography showed that single vessel disease in 31 cases(43.1%), double-vessel disease in 25 cases (34.7%),triple-vessel disease in 16 cases(22.2%). All these patients were performed PTCA and stenting. Results The procedure success rate was 97.2%(70/72). The two failed cases mainly because the guide-wire could not cross the occluded lesion. Among these 70 patients, 91 stents were implanted in. With 30 days follow-up after the procedure, 61 patients were symptoms free or obviously relief. 2 patients occurred ST-elevation acute myocardial infarction. 4 patients with multi-vessel disease need revascularization in the other target lesion. 3 patients were transfered to surgeon for CABG. 2 patients dead,one died in home for sudden death,the other one died in hospital for ventricular fibrillation. Conclusion Percutaneous coronary intervention is a safe and feasible treatment for non-ST-segment elevation acute coronary syndrome.