心肌呈色分级评价急性心肌梗死溶栓疗法的疗效Myocardial reperfusion evaluated by myocardial blush grade after thrombolysis in acute myocardial infarction
吕安康,沈卫峰,张继盛,张大东,张宪郑,爱芳
摘要(Abstract)：
目的 以心肌呈色分级 (MBG)评估急性心肌梗死溶栓后的心肌灌注状况。方法 89例急性心肌梗死患者给予重组组织型纤溶酶原激活剂治疗。各例于给药后 90分钟行冠状动脉造影 ,观察梗死相关动脉前向血流 ,评估心肌灌注情况 ,并记录 6个月心脏事件发生率。结果 溶栓后符合临床再通标准的为 87 6 % ,未再通的为 12 4%。冠状动脉造影结果显示 ,全组梗死相关动脉的再通率 (TIMI 2或 3级 )为 82 % ;心肌再灌注率 (MBG 2或 3级 )为 88 8% ,完全再通 (TIMI 3级 )且完全心肌再灌注 (MBG 3级 )者为 40 4%。 6个月死亡率为 10 1%。多因素分析结果表明 ,入院时Killip分级和MBG分级是急性心肌梗死死亡的主要独立预测因子 (P =0 0 0 0 1)。结论 成功的再灌注治疗应该是梗死相关动脉前向血流TIMI 3级且伴良好心肌灌注。
关键词(KeyWords)： 急性心肌梗死;溶栓治疗;心肌呈色分级;心肌灌注
基金项目(Foundation):
作者(Author): 吕安康,沈卫峰,张继盛,张大东,张宪郑,爱芳
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