急性心肌梗死择期冠脉介入治疗时间对心肌再灌注的影响

Effect of the time of delayed percutaneous coronary intervention on myocardial tissue reperfusion

目的通过测定急性心肌梗死(AMI)患者在不同时间行择期经皮冠状动脉支架植入术(PCI)后的梗死相关血管(IRA)的TIMI血流分级及校正TIMI帧数(CTCF),来探讨急性心肌梗死择期PCI时间对心肌再灌注的影响。方法60例急性心肌梗死,但已错急诊PCI手术时机病例60例,按发病后12 h^7 d(20例)、8~30 d(40例)期间行PCI治疗分为2组,测定各组内AMI患者PCI术后梗死相关动脉TIMI血流分级及校正TIMI帧数。结果 60例急性心肌梗死患者经择期PCI治疗后无死亡病例,12 h^7 d组中TIMI血流<3级的患者较多(40%vs 12.5%,P<0.05);CTFC大于等于30帧的患者较多(45%vs 17.5%,P<0.05);CTFC较高(30.1±4.99 vs 19.2±4.18,P<0.05),差异有统计学意义。结论急性心肌梗死患者在8~30 d内行择期PCI能使心肌得到更好的灌注。

Objective To explore the effect of the time of delayed percutaneous coronary intervention（PCI） on myo- cardial tissue perfusion,we tested TIMI blood stream and corrected TIMI frame count（CTFC） of infract -related artery after PCI. Methtl4s Sixty patients with acute myocardial infraction（AMI）, who missed the the emergency PCI were divided into two groups. The first group accepted PCI between twelve hours and seven days after AMI, the second group accepted PCI be- tween eight days and thirty days after AMI. We tested the TIMI blood stream and CTFC of infract - related artery in the two groups. Results No patients died after PCI. In the first group,the ratio of the patients whose TIMI less than three was more than the second one （40% vs 12. 5% ,P 〈0. 05） ,the ratio of the patients whose CTFC more than thirty was more than the second group（45% vs 17.5% ,P 〈0. 05） ,the average of CTFC in the first group was higher than the second group（30. 1 ± 4. 99 vs 19. 2 ± 4. 18 ,P 〈 0. 05 ）. Condusion Patients who accepted delayed PCI between eight and thirty days after acute period of AMI can receive better myocardial tissue perfusion.