摘要
目的比较研究急性心肌梗死患者行经皮冠状动脉腔内介入治疗(PCI)的时机选择与慢血流/无复流(SNR)现象的关系。方法选择272例急性心肌梗死行PCI治疗的患者为研究对象。TIMI2级血流患者136例,其中60例24h内施行即刻PCI,28例在梗死后24h至一周施行PCI,48例一周后至一月内行PCI;TIMI3级血流患者136例,其中62例在急性心肌梗死发病24h内行PCI,31例发病24h至一周内行PCI,43例一周后至一月内行PCI。分别比较各组的一般情况,冠脉造影梗死相关血管(IRA)行PCI前后的血流情况。结果TIMI2级血流组和TIMI3级血流组中24h至一周内行PCI治疗的患者SNR发生率显著高于24h内即刻PCI组和一周后择期PCI组(8/60vs22/28,22/28vs16/48,P均<0.05)(14/31vs6/62,14/31vs4/43,P均<0.05),且在TIMI2级血流组中即刻PCI组的SNR发生率明显低于一周后择期PCI组(8/60vs16/48,P<0.05);TIMI3级血流组中即刻PCI组的SNR发生率与一周后择期PCI组无差异(6/62vs4/43,P<0.05);TIMI2级与TIMI3级血流组在24h至一周内行PCI的患者SNR的发生率差异显著(22/28vs14/31,P<0.05)。结论急性心肌梗死患者即刻PTCA的血流恢复优于择期PTCA,尤其TIMI血流≤2级的患者。
Objective To compare the effect of time choice on Slow-flow No-reflow（SNR） phenomena in patients with acute myocardial infarction（AMI） who underwent pereutaneous coronary intervension（PCI）. Methods 272 patients receiving PCI were enrolled. According to TIMI flow, the patients were divided into 2 study populations, who were divided into 3 groups according to immediate PCI or elective PCI, respectively. Results Patients receiving PCI from 24h to one week had more incidence of SNR according to 2 study populations（22/28 vs 8/60, 22/28 vs 16/48 P 〈 0.05） （ 14/31 vs 6/62, 14/31 vs 4/43, P 〈 0.05）. Furthermore, patients of immediate PCI had less SNR incidence than those receiving PCI from one week to one month according to TIMI grade 2（8/60 vs 16/48, P 〈0. 05）. Achievement of TIMI flow grade 3 according to TIMI grade 3 had no significant difference in patients receiving PCI from 24h to one week and those immediate PCI （6/62 vs 4/43, P 〈0.05）. Patients receiving PCI from 24h to one week had higher mortality of SNR in TIMI grade 2 group, compared with 37MI grade 3 group（22/28 vs 14/31, P 〈 0.05）. Conclusion Patients with AMI who underwent immediate PCI had less SNR incidence than those of patients who received elective PCI.
出处
《中国微循环》
北大核心
2007年第6期393-395,共3页
Journal of Chinese Microcirculation
