张耘博,赵汉军,盛兆雪,周鹏,刘臣,周金英,管宇,江暑添,宋莉,颜红兵

• 1:国家心血管病中心北京协和医学院中国医学科学院阜外医院冠心病中心

摘要(Abstract)：

目的探讨急性广泛前壁或前壁ST段抬高型心肌梗死(STEMI)左心室附壁血栓(LVT)的发生率、危险因素及体循环栓塞发生率、治疗方案和预后。方法回顾性纳入2014年1月1日至2017年12月31日就诊于中国医学科学院阜外医院的急性广泛前壁或前壁STEMI患者1245例。收集1245例患者急诊就诊时、直接经皮冠状动脉介入治疗(PCI)术后当日、PCI术后连续3 d以及术后1周经胸超声心动图(TTE)检查结果,根据结果诊断LVT者39例,并以简单随机法抽取40例无LVT者作为对照组。对两组患者进行随访,主要临床终点为体循环栓塞事件。结果 LVT组共39例(3.1%,39/1245),39例患者中广泛前壁STEMI 26例(66.7%)、前壁STEMI 13例(33.3%);非LVT组40例。两组随访12个月,LVT组体循环栓塞1例(2.6%),非LVT组体循环栓塞0例;LVEF<40%是发生LVT的独立危险因素(OR 11.696,95%CI 2.620～52.215,P=0.001)。结论 LVT在急性广泛前壁或前壁STEMI患者中发病率为3.1%,体循环栓塞事件发生率为2.6%。LVEF<40%为LVT发生的独立危险因素。

关键词(KeyWords)： 左心室附壁血栓;ST段抬高型心肌梗死;体循环栓塞

Abstract:

Keywords:

基金项目(Foundation): 中国医学科学院医学与健康科技创新工程基金(2016-I2M-1-009)

作者(Author): 张耘博,赵汉军,盛兆雪,周鹏,刘臣,周金英,管宇,江暑添,宋莉,颜红兵

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