青年中高危不稳定型心绞痛患者早期冠状动脉介入治疗临床分析

Clinical analysis of the young patients with high-risk of unstable angina who had undergone the primary interventional therapy

目的:回顾性分析青年中高危不稳定型心绞痛(UAP)患者早期冠状动脉介入治疗(PCI)的近期疗效。方法:将25例青年中高危UAP(TIMI危险评分≥3分)患者,分为早期PCI组(14例)和延迟PCI组(11例)。观察2组患者术中病变情况、血栓负荷、记录30 d内心脏事件(包括心绞痛、急性心肌梗死、猝死、再次PCI及冠状动脉搭桥手术)的发生率及住院时间等。结果:2组冠状动脉病变及PCI情况相似,早期PCI组血栓负荷相对较多。与延迟PCI组相比,早期PCI组能降低30 d内心绞痛发生率,能够缩短症状缓解及住院时间(P<0.05)。结论:对于青年中高危UAP患者应该优先选择早期PCI。

Objective：To analysis the short-term and the long-term therapic effects on young patients with high-risk of unstable angina who had undergone the primary interventional therapy.Method：Twenty-five young patients with high risk of unstable angina（TIMI harzard stratification ≥3） were divided into two groups with primary interventional therapy（n=14） and delayed interventional therapy（n=11）.The lesion of coronary artery,thrombus budren and arrhythmia were observed respectively.The incidence rate of cardiacvascular events（include angina,AMI,sudden death,interventional therapy again and coronary artery bypass graft） in the thirty days and the length of stay were recorded.Result：The lesion of coronary artery and the state of interventional therapy in the two groups are similar,the thrombus burden in the group with the primary interventional therapy is relatively more than the group with delayed interventional therapy.Compared to the group with delayed interventional therapy,The incidence rate of angina in the thirty days and the length of symptomatic relief and stay in the group with the primary interventional therapy were shorter（P0.05）.Conclusion：We should evaluate the risk factors and choose the optimal individualized strategy in the young patients with unstable angina according to the risk stratification.The primary interventional therapy is the first chosen to the patients with middle and high-risk of unstable angina.