急性冠状动脉综合征介入治疗4670例近期疗效的评价

Percutaneous coronary intervention in acute coronary syndrome: single center experience from 4670 patients

目的分析过去15年经皮冠状动脉介入(PCI)治疗急性冠状动脉综合征(ACS)患者的近期临床疗效。方法1989年8月至2004年10月沈阳军区总医院心血管内科对4670例住院的ACS患者行PCI治疗,其中发病30d内的急性心肌梗死(AMI)患者1750例(37.5%),不稳定心绞痛患者2920例(62.5%)。评价PCI的成功率、合并症及住院期间近期临床疗效。结果PCI总的病例成功率为98.1%(4579/4670),AMI行急诊PCI者梗死相关动脉开通率98.2%(825/840)。住院期间共死亡52例(总病死率1.1%),其中术中死亡2例(术中病死率0.04%)。总的PCI相关并发症发生率为6.5%(304/4670)。从入院至PCI时间为3.5d±2.1d,平均住院12d±8d。结论PCI治疗ACS成功率高,术中、术后死亡率和手术相关并发症发生率低,近期疗效好。

Objective To explore the in-hospital effect of percutaneous coronary intervention (PCI) on patients with acute coronary syndrome (ACS).Methods The clinical data of 4670 hospitalized patients with ACS, 1750 with acute myocardial infarction (AMI, 37.5 %) within 30 days and 2920 with unstable angina pectoris (62.5%), undergoing PCI from August 1989 to October 2004, were analyzed.Results^The total success rate of PCI procedure was 98.1 % (4579/ 4670) for all patients, and the patency rate of infarction related artery of emergency PCI was 98.2 % (825/840) in the patients with AMI onset within ~24 h. The complication rate related to PCI procedure was 6.5 % (304/4670). The total in-hospital mortality was 1.1 % (52/ 4670) and the mortality during PCI procedure was 0.04 % (2/4670). The duration from admission to PCI was 3.5 days ± 2.1 days and the whole hospital stay was 12 days±~8 days.Conclusion The success rate of PCI procedure in patients with ACS is high, while the in-hospital mortality and the complication rates are low, which shows that PCI has an ideal short-term effect in patients with ACS.