低帧率方案在急诊经皮冠状动脉介入治疗中安全性和可行性研究

Safety and feasibility of a low frame rate protocol for primary percutaneous coronary intervention

目的观察低帧率方案对急诊经皮冠状动脉介入治疗(PCI)的可行性及安全性.方法回顾性分析2015年10月至2017年10月期间于天津市第四中心医院行急诊PCI的ST段抬高型急性心肌梗死(STEMI)患者480例,常规方案(OR)组227例,应用15帧/s方案;低帧率方案(LR)组253例,应用7.5帧/s方案.记录术中剂量面积乘积(DAP)和透视时间(FT).两组患者均随访1年,记录住院期间及随访1年期间主要不良心血管事件(MACE),包括全因死亡,心原性猝死,非致死性心肌梗死,非致死性心力衰竭.结果LR组FT与OR组差异无统计学意义(P>0.05),但LR组DAP明显低于OR组(P<0.01).两组患者住院期间及1年随访期间MACE的发生率差异无统计学意义(P均>0.05).结论对于急诊PCI患者应用低帧率方案具有良好的可行性及安全性.

Objective To observe the feasibility and safety of a low frame rate protocol for primary percutaneous coronary intervention(PCI).Methods Retrospective analysis of 480 patients with ST-segment elevation acute myocardial infarction(STEMI)treated by primary PCI from October 2015 to October 2017 including 227 cases in the ordinary frame rate fluoroscopy(OR)group(fluoroscopy at 7.5 frames per second)and 253 cases in the low frame rate fluoroscopy(LR)group(fluoroscopy at 15 frames per second).Dose area product(DAP)and fluoroscopy time(FT)were recorded during intervention.Two groups were followed up for 1 years.Major adverse cardiovascular events(MACE),including all-cause mortality,sudden cardiac death,non-fatal myocardial infarction and non-fatal heart failure,were recorded during hospitalization and 1-year follow-up.Results There was no significant difference in FT between OR group and LR group(P>0.05).However,DAP was significantly lower in LR group than OR group(P<0.01).There was no significant difference in the incidence of MACE between the two groups during hospitalization and 1-year follow-up(both P>0.05).Conclusion The low frame rate protocol is feasible and safe for primary PCI patients.