急性心肌梗死冠状动脉内长支架置入术临床疗效The clinical efficacy of long coronary stenting after acute myocardial infarction
陈步星,王伟民,赵红,胡大一,赵明中,卢明瑜,刘健,吴淳
摘要(Abstract)：
目的 评价急性心肌梗死相关动脉弥漫或长病变置入长支架的临床疗效。方法 对10 5例急性心肌梗死 (AMI)患者行原发冠状动脉内支架术。将 5 7例AMI患者梗死相关动脉弥漫或长病变置入冠状动脉内支架长度≥ 2 0mm为长支架组 (A组 ) ,另 48例梗死相关动脉病变相对较短 ,置入支架长度 <2 0mm作为对照组 (短支架组 ,B组 )。比较两组之间的临床特征、冠状动脉造影情况及置入支架后的临床效果。结果 A组与B组之间有关年龄、性别、发病开始至心导管室时间、心肌梗死部位、心功能Killip分级、冠状动脉病变支数、具体梗死相关动脉病变血管和支架置入前梗死相关动脉血流TIMI分级 ,两组之间无统计学差异。A组患者侧支循环形成及经皮冠状动脉腔内成形术 (PT CA)后严重夹层形成明显多于B组。A组患者支架置入长度明显长于B组 [(2 6 0 2± 4 77)mm比(16 0 2± 2 40 )mm ,P <0 0 0 1]。两组之间置入支架直径无统计学差异。A组支架置入成功率为96 5 %,与B组 95 7%相似。支架置入后A组TIMI血流 3级为 93 3%,与B组的 91 7%相比 ,差异无显著性。A组中有 1例患者术后 3d支架处血栓形成。A组中 5 1例和B组中 41例患者术后随访 1～39个月 ,其中A组中 3例及B组中 4例因心绞痛再次入院行冠状动脉造影检查 ,A组 1例为再狭窄
关键词(KeyWords)： 心肌梗塞;支架
基金项目(Foundation):
作者(Author): 陈步星,王伟民,赵红,胡大一,赵明中,卢明瑜,刘健,吴淳
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