急性心肌梗死合并心源性休克患者急诊介入治疗近远期疗效分析

目的观察急性心肌梗死(AMI)合并心源性休克(CS)患者行经皮冠状动脉介入术(PCI)治疗后的近期及远期疗效。方法收集2006年3月至2012年9月收治的AMI合并CS行PCI治疗的99例患者资料,统计患者临床高危因素、冠脉造影及介入特点,观察患者的主要不良心血管事件(MACE)发生情况。结果术后住院期间16例(16.2%)死亡。患者术后1个月、6个月、1年、3年,死亡率分别为17.2%、22.2%、22.2%、27.3%;急性心梗发生率分别为0、1.0%、1.0%、3.0%;靶血管重建发生率分别为1.0%、3.0%、6.1%、11.1%;MACE发生率分别为18.2%、26.3%、29.3%、39.4%。结论急诊PCI治疗对AMI合并CS患者有显著疗效,其主要优势为再通快、TIMI血流3级率高,近期及远期病死率降低。

Short-term and long-term effect of percutaneous coronary intervention in patients with cardiogenic shock following acute myocardial infarction

Objective To observe the short-term and long-term effect of acute myocardial infarction ( AMI ) combined with cardiac shock( CS) in patients with percutaneous coronary intervention( PCI) treatment. Methods A retrospective study was performed on 99 patients with AMI combined with CS who underwent PCI from March 2006 to September 2012. The clinical risk factors,characteristics of coronary angiography and intervention were statistically analyzed,and the major adverse cardiac events( MACE) were observed. Re-sults There were 16 cases(16. 2%) died during the postoperative hospitalization. The death rates of 1 months,6 months,1 year,3 years were 17. 2%,22. 2%,22. 2% and 27. 3%,respectively. The incidence of acute myocardial infarction were 0,1. 0%,1. 0% and 3. 0%,respectively. The target vessels reascularization rates were 1. 0%,3. 0%,6. 1% and 11. 1%,respectively. The incidence of MACE were 18. 2%,26. 3%,29. 3% and 39. 4%,respectively. Conclusion Emergency PCI in patients with acute myocardial infarc-tion complicating cardiac shock has significant curative effect,its main advantage is fast recanalization and TIMI flow level 3 rate is high,and the immediate and long-term mortality reduction.