直接经皮穿刺冠状动脉介入治疗青年患者急性心肌梗死的疗效评价

DIRCET PERCUTANEOUS CORONARY INTERVENTION IN ACUTE MYOCARDIAL IFARCTION IN YOUTH

目的探讨直接经皮穿刺冠状动脉介入(PCI)治疗40岁以下青年急性心肌梗死(AMI)的临床疗效。方法38例40岁以下青年AMI患者,发病12h内直接PCI。观察出院前后心脏事件和左室射血分数(LVEF)。结果全部病例冠状动脉造影示梗死相关血管血流TIMI0～1级,PCI后全部达TIMI3级血流,住院期间无心脏事件发生。随访30～84个月,除2例不能控制危险因素,不坚持服药而发生原部位再梗死需再次PCI,余36例无心脏事件发生。8例术后6个月复查冠状动脉造影未发现再狭窄。术后6～12个月测LVEF比出院时明显增高[(61.8±10.2)%比(52.3±11.5)%,P<0.05)]。结论青年患者AMI时直接PCI安全可行,有很好的近期和远期疗效。

Objective To assess the clinical efficacy and safety of direct percutaneous coronary intervention(PCI)in acute myocardial ifarction(AMI)in younger patients (under 40 years). Methods PCI was performed in 38younger AMI(within 12hours).The cardiac events and left ventricular ejection fraction(LVEF)were recorded during hospitalization and follow-up. Results The procedural was success in 38younger patients.Durign follow-up(30～84months),2 patients need revascularization of target vessel because they didn't contral risk factors and take medicines.There was no cardiac events during and out hospital.LVEF was significantly increased[(61.8±10.2)%vs (52.3±11.5)%,P<0.05]Repeat coronary angiography in 8 patients(6 months late)showed no Restenosis in infarct-related artery. Conclusion Direct PCI for younger AMI was safe and has a good results in immediate and long-term.