直接支架术对急性冠脉综合征无复流的影响

Effect of direct stenting on the no-reflow phenomenon in acute coronary syndrome

目的 评价直接支架术对急性冠脉综合征(ACS)患者无复流现象的影响。方法 203例急性冠脉综合征患者分为直接支架术79例与常规支架术124例,分析其罪犯病变血管术中无复流现象的发生率,并随访观察其对急性期心脏事件的影响。结果直接支架术中发生无复流现象4例(5.1％),常规支架术中发生无复流现象18例(14.5％)(P<0.05)。22例发生无复流的患者,件院期间心脏负性事件的发生率与未发生无复流现象者比较明显增高(27％vs 7％,P<0.01)。结论 直接支架术有助于降低ACS患者无复流现象的发生率;发生无复流现象预示着较高的负性预后事件。

Objective To evaluate the effect of direct stenting technique on the no-reflow phenomenon in acute coronary syndrome(ACS). Methods Two hurdred and three cases of ACS with intact data were retrospectively analysed according to direct stenting(n =79) or routine stenting(n=124) ( predilatation then provisional stenting) technique. The no-reflow rates and major cardiac events( MACEs) were recorded during the procedure and hospitali-zation. Results No-reflow occurred in 4 cases of the direct stent group and 18 of the 124 routine stent group (5.1% vs 14.5% respectively)( P<0.05) ; compared with without no-reflow group, patients with no-reflow had significantly higher MACEs rates(27% vs 7% )(P<0.01). Conclusion Direct stenting is useful in reducing the no-reflow rate and no-reflow is associated with a higher MACEs rate in ACS patients.