直接冠状动脉内支架置入术对急性心肌梗死无复流的影响The effect of direct stenting on no-reflow in patients with acute myocardial infarction
陈玉国 ,徐峰 ,张运 ,李继福 ,李贵双 ,纪求尚 ,刘同涛
摘要(Abstract)：
目的评价直接冠状动脉(冠脉)内支架置入术对ST段抬高型急性心肌梗死无复流的影响。方法对157例ST段抬高型急性心肌梗死患者分别行直接冠脉内支架置入(直接支架组,85例)和球囊预扩张后支架置入(常规支架组,72例)。比较两组介入治疗时平均X线曝光时间、造影剂用量、术后TIMI血流分级和心电图ST段变化。结果直接支架组和常规支架组比较,前者节省球囊,平均X线曝光时间和造影剂用量均显著降低[(24.6±16.9)minvs(34.4±17.5)min,(115±37)mLvs(166±61)mL;P均<0.05];二者术后TIMI3级差异无统计学意义(91.8%vs83.3%,P=0.107);前者TIMI0~1级未见显著降低,但有明显的下降趋势(3.5%vs11.1%,P=0.064);前者心电图ST段无回落发生率显著降低(22.4%vs41.7%,P=0.009)。结论对于ST段抬高型急性心肌梗死中适当的冠脉病变,直接冠脉内支架置入术不仅可以节省球囊,减少X线曝光时间和造影剂用量,而且可能减少无复流发生。
关键词(KeyWords)： 心肌梗死;血管成形术,经腔,经皮冠状动脉;支架
基金项目(Foundation):
作者(Author): 陈玉国 ,徐峰 ,张运 ,李继福 ,李贵双 ,纪求尚 ,刘同涛
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