直接冠状动脉介入治疗时无复流高危患者是否应用Guardwire Plus装置的对比研究A controlled study of applying Guardwire Plus device in high risk patients with no-reflow during primary percutaneous coronary intervention
颜红兵 ,朱小玲 ,高海 ,李南 ,李世英 ,艾辉 ,王健 ,柯元南
摘要(Abstract)：
目的评估在对发生无复流高危患者行直接经皮冠状动脉介入治疗(PCI)时是否应用GuardwirePlus远端保护装置对无复流发生率及死亡率的影响。方法将没有应用远端保护装置年代的患者作为对照组(232例),确定发生无复流的高危因素。将使用远端保护装置年代的患者作为研究组(185例),常规在发生无复流的高危患者应用GuardwirePlus远端保护装置。对比分析两组的即刻和随访结果。结果对照组25例(10.8%)患者发生无复流。分析显示,无复流现象更多见于梗死相关动脉为粗大右冠状动脉并合并高血压病和高脂血症的患者。发生无复流后的住院死亡率为16%(4例/25例)。研究组3例(1.6%)患者发生无复流,但其中2例时间较短(<3h),无一例因发生无复流而死亡。与对照组相比,研究组的无复流发生率、ST段回落率、发生无复流后的住院死亡率以及存活患者的心功能差异均有统计学意义。结论在对发生无复流的高危患者行直接PCI时可能需要常规应用GuardwirePlus远端保护装置。应用GuardwirePlus运端保护装置可以大大降低无复流发生率和发生无复流后的住院死亡率。
关键词(KeyWords)： 心肌梗死;血管成形术,经腔,经皮冠状动脉;远端保护装置;无复流
基金项目(Foundation):
作者(Author): 颜红兵 ,朱小玲 ,高海 ,李南 ,李世英 ,艾辉 ,王健 ,柯元南
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