STEMI急诊PCI后多支冠脉病变治疗的评价

目的 对ST段抬高急性心肌梗死(STEMI)伴多支冠状动脉病变的患者,急诊经皮冠状动脉介入(PCI)后,比较药物治疗或择期PCI处理非梗塞相关血管的临床疗效,评估STEMI后对非梗塞相关血管的最佳处理方法.方法 分析比较了151例伴多支冠状动脉病变行急诊PCI处理梗塞血管的STEMI患者,根据对非梗塞相关血管不同处理方式分为两组,组1为心梗后7-14d行择期PCI者共64例,组2为药物治疗者共87例.比较两组病情变化、造影资料、住院期间及远期严重心血管不良事件(MACE)的发生情况.结果 两组临床情况及造影结果相似;组1病人的住院日为(16.98±5.84)d,较组2病人(11.29±5.00)d长,二者比较P=0.000;院内MACE发生率在组1为4.69%、组2为4.60%,院外MACE发生率在组1为3.13%、组2为13.79%,二者比较院内MACE差异无统计学意义,随访MACE差异有统计学意义(P=0.026).结论 STEMI伴多支冠脉病变患者急诊PCI后,再择期行PCI术,远期MACE发生率低于药物治疗.

Clinical study of different treatment strategy for AMI patients treated by primary PCI with multi-vessel coronary artery disease

Objective To observe the clinical outcome of patients with acute myocardial infartion(AMI) and multivessel coronary disease(MVD) undergoing primary percuteneous coronary intervention(PCI),whether staged PCI or drug therapy.Evaluate optimal treatment strategy of non-culprit vessels.Methods Data of 151 patients with STEMI and MVD treated by primary PCI were analyzed.Patients were divided into 2 groups,Group 1(n=64)with staged PCI of non-culprit vessels after primary PCI 7-14days,Group 2(n=87)with drug therpy....