冠状动脉重建术治疗非ST段抬高急性心肌梗死的临床意义

Clinical Significance of Coronary Revascularization in Patients with non ST Segment Elevation Myocardial Infarction

目的:比较冠状动脉重建术治疗和药物保守治疗对非ST段抬高急性心肌梗死患者的临床效果。方法:对194例非ST段抬高急性心肌梗死患者入院后行冠状动脉重建术(CR)治疗[冠脉介入(PCI组)或冠脉搭桥术(CABG组)]或药物保守治疗(药物保守组),并进行12个月的随访,比较2组患者的一般临床资料、冠脉造影血管病变情况及心源性死亡、心绞痛复发、再次入院和再次血运重建术情况。结果:于入院至随访12个月期间药物保守组心源性死亡高于PCI组、心绞痛复发高于CABG组(P<0.05);PCI组在心绞痛复发例数方面高于CABG组(P<0.05)。结论:对非ST段抬高急性心肌梗死患者入院后行冠脉重建术治疗是安全的,能够降低病死率及心绞痛复发率,改善患者的预后。

Objective： To compare the clinical effects of coronary revascularization （CR） and pharmaceutical treatment in patients with non-ST segment elevation myocardial infarction. Methods： One hundred and ninety-four cases with non-ST segment elevation myocardial infarction who underwent CR （percutaneous coronary intervention, PCI group and coronary artery bypass grafting, CABG group ） and pharmaceutical treatment were enrolled in the study. All patients were followed up for 12 months. General clinical data,angiographic characteristics of coronary artery lesions,rate of cardiac death, reoccurrence of angina, re-revascularization, and re-hospitalization were analyzed. Results： The rate of cardiac death and reoccurrence of angina in the group of pharmaceutical treatment were higher than that in CR group significantly （P 〈 0.05 ）. Reoccurrence of angina in PCI group was higher than that in CABG group （P 〈 0.05）. Conclusion： Coronary revascularization strategies in patients with non-ST segment elevation myocardial infarction were safe. It can decrease the rate of cardiac death and reoccurrence of angina, and improve the clinical prognosis.