徐艺芮,王怀根,梁焱娇,王东琦

• 1:西安交通大学第一附属医院心内科

摘要(Abstract)：

目的探讨合并多支血管病变(MVD)的ST段抬高型心肌梗死(STEMI)非罪犯血管行经皮冠状动脉介入治疗(PCI)的最佳时机及其对患者预后的影响。方法共收集2015年1月至2018年12月就诊于西安交通大学第一附属医院的367例STEMI合并MVD行急诊PCI干预罪犯血管并择期干预非罪犯血管的患者,根据非罪犯血管的干预时间将患者分为三组:组1(在急诊PCI术后1～3 d干预非罪犯血管)、组2(在急诊PCI术后3～7 d干预非罪犯血管)、组3(在急诊PCI术后7～30 d干预非罪犯血管)。对这些患者进行了22(10,37)个月的随访,主要研究终点为全因死亡及主要不良心脑血管事件(MACCE),其中MACCE包括心原性死亡、非致死性心肌梗死、卒中、再次血运重建、因心力衰竭或心绞痛再入院。结果在中位时间为22个月的随访期间,组1的138例患者中共有36例(26.09%)发生MACCE,组2的173例患者中共有40例(23.12%)发生MACCE,组3的56例患者中共有24例(42.86%)发生MACCE。MACCE的发生率上,组1与组2比较差异无统计学意义(HR 1.20,95%CI0.76～1.89,P=0.42),而组3的发生率高于组1和组2(HR 1.94,95%CI 1.08～3.46,P=0.01;HR 2.28 95%CI1.25～4.16,P<0.001)。结论 1周内干预非罪犯血管对STEMI合并MVD患者的预后有利,应在行急诊PCI干预罪犯血管后的1周内干预非罪犯血管。

关键词(KeyWords)： ST段抬高型心肌梗死;多支血管病变;经皮冠状动脉介入治疗;非罪犯血管

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 徐艺芮,王怀根,梁焱娇,王东琦

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