王耿,韩雅玲,荆全民,王守力,马颖艳,王效增,王斌

• 1:中国人民解放军沈阳军区总医院心内科

摘要(Abstract)：

目的研究急性心肌梗死(AMI)患者梗死相关血管(IRA)病变为分叉病变时,对急诊经皮冠状动脉介入治疗(PCI)疗效的影响。方法对2004年1月至2008年6月沈阳军区总医院心内科1209例发病在12h内的AMI患者行急诊冠状动脉造影及PCI,包括急性ST段抬高型心肌梗死1037例、急性非ST段抬高型心肌梗死172例,其中梗死相关病变为分叉病变的患者(分叉病变组,BF)247例(20.4%),为非分叉病变的患者(非分叉病变组,NBF)962例(79.6%)。观察BF组患者的冠状动脉造影特点、急诊PCI的成功率及术后1年主要心血管事件(MACE)发生率。结果 BF组和NBF组患者年龄、性别、心功能Ⅲ～Ⅳ级、合并糖尿病、高血压、吸烟、高胆固醇血症、陈旧性心肌梗死病史比率差异无统计学意义。所有病变均置入药物洗脱支架。BF组中220例(89.1%)只在主支置入支架,102例(41.3%)应用导丝保护边支,27例(10.9%)主支及边支均置入支架。BF组与NBF组主支PCI成功率差异无统计学意义(96.8%比98.2%,χ2=2.10,P=0.15),术后住院期间MACE发生率差异无统计学意义(4.9%比3.2%,χ2=1.53,P=0.22),术后1年随访两组MACE发生率差异也无统计学意义(14.2%比12.5%,χ2=0.51,P=0.48)。结论 AMI患者IRA病变为分叉病变时,急诊PCI治疗有较高成功率,近期及远期疗效与AMI患者非分叉病变类似。

关键词(KeyWords)： 心肌梗死;血管成形术,经腔,经皮冠状动脉;冠状动脉疾病;治疗结果

Abstract:

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基金项目(Foundation): 全军首批临床高新技术重大项目课题([2002]卫医字第18号)

作者(Author): 王耿,韩雅玲,荆全民,王守力,马颖艳,王效增,王斌

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