张奇,邱建平,张瑞岩,王海蓉,胡健,张健盛,杨震坤,沈卫峰

• 1:上海交通大学医学院附属瑞金医院心内科
• 2:上海浦东新区公利医院心内科

摘要(Abstract)：

目的分析药物洗脱支架(DES)血栓形成引起急性ST段抬高型心肌梗死(STEMI)的临床和直接冠状动脉介入治疗(PCI)特征及预后。方法31例因DES血栓形成引起STEMI(ST组)和93例由原发冠状动脉病变所致STEMI患者(对照组)接受直接PCI治疗。记录各例临床和PCI特征及1年随访结果。研究主要终点为院内及1年累积主要心脏不良事件(MACE),包括死亡、非致命性再梗死及靶血管再次血运重建(TVR)。结果与对照组比较,ST组年龄较大(69.9±11.4岁比63.7±13.6岁,P=0.01),糖尿病(41.9%比22.6%,P=0.04)和既往心肌梗死史(29.0%比11.8%,P=0.02)明显增多;直接PCI后冠状动脉TIMI 3级血流显著降低(45.2%比92.5%,P<0.001)。ST组院内死亡率(16.1%比3.2%,P=0.01)和MACE发生率(25.8%比7.5%,P=0.007)显著增高,术后1年总生存率及无MACE生存率显著降低(分别为77.4%比92.5%,P=0.016;59.4%比85.1%,P=0.001)。结论DES血栓形成引起STEMI患者即使接受直接PCI治疗,其院内死亡及MACE发生率仍显著高于由原发冠状动脉病变所致的心肌梗死患者。

关键词(KeyWords)： 支架;冠状动脉血栓形成;心肌梗死

Abstract:

Keywords:

基金项目(Foundation): 上海市科委重大课题研究资助(05DZ19503)

作者(Author): 张奇,邱建平,张瑞岩,王海蓉,胡健,张健盛,杨震坤,沈卫峰

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