急诊冠状动脉内支架术治疗ST段抬高急性心肌梗死

目的 评价急诊冠状动脉内支架术治疗急性心肌梗死(AMI)的安全性和临床疗效。方法 选择自1999年12月至2002年12月间我院69例急性心肌梗死患者，起病12小时内，所有病例均未行静脉溶栓治疗，即刻送导管室行冠状动脉造影术，明确梗死相关动脉(IRA)，球囊预扩张后，冠状动脉内置入支架。结果 69例急性心肌梗死患者中，左前降支病变刃例，左回旋支病变2例，右冠状动脉病变28例，原则上干预梗死相关动脉(IRA)，共置入支架72枚，手术成功率100％，所有患者支架置入后TIMI血流3级67例，2级2例。术后无心脏事件发生。结论 急性心肌梗死患者行急诊冠状动脉内支架术安全有效，且效果优于溶栓治疗。

Primary stenting in acute myocardial infarction with ST-elevation

Objective: To evaluate the efficacy and reliability of primary stenting in acute myocardial infarction with ST-elevation.Methods: A total of 69 patients with acute myocardial infarction within 12 hours of onset of symptoms were enrolled between January 2000 and Dec 2002 in our hospital. All the patients were not treated with intravenous thrombolysis and send to the lab of cardiac catheterization immediately. Coronary angiography was performed to definite the infarct related artery and stents were implanted at the culprit lesions after predilation.Results: There were 39 culprit lesions at left anterior descending coronary artery, 2 culprit lesions at left circumflex, and 28 culprit lesions at right coronary arteries in all the 69 patients. The lesions were not intervened except the infarct related artery in principle. 72 stents were placed at the coronary lesions, and a TIMI grade III flow was achieved in 67 patients, TIMI grade II flow was achieved in 2 patients. All the procedures succeed and no major adverse cardiac events occurred.Conclusions: The treatment of primary stenting in acute myocardial infarction is safe, efficacy and had better effects than intravenous thrombolysis.