不同类型急性心肌梗死早期介入治疗效果的比较

Comparison of Early Intervention in Patients with Different Types of Acute Myocardial Infarction

目的:比较急性非ST段抬高型心肌梗死(NSTEMI)和急性ST段抬高型心肌梗死(STEMI)患者接受早期再灌注治疗后冠脉血流、心肌灌注及心功能情况的差异。方法:接受早期再灌注治疗的急性心肌梗死患者共168例,分为NSTEMI组55例和STEMI组113例,比较2组患者的术后心肌呈色分级(MBG),术前及术后的溶栓治疗(TIMI)血流分级、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV),左室质量(LVW)、左室质量指数(LVWI)及左室射血分数(LVEF)。结果:2组术后TIMI血流情况、LVEDV、LVW及LVWI差异无统计学意义(P>0.05),但NSTEMI组术前TIMI血流3级的比例、术后MBG3级比例和LVEF明显优于STEMI组,差异有统计学意义(P<0.05或P<0.01)。结论:NSTEMI患者接受早期介入治疗术后的心肌再灌注情况以及左室收缩功能优于STEMI患者。

Objective： To compare the coronary flow, reperfusion of the ischemic myocardium and cardiac function in patients with acute non-ST elevation myocardial infarction （NSTEMI） and acute ST elevation myocardial infarction （STEMI）, who received early invasive intervention strategy. Methods： A total of 168 patients with acute myocardial infarction undergoing early coronary intervention were enrolled, including 55 patients with NSTEMI （NSTEMI group） and 113 patients with STEMI （STEMI group）. The myocardial blush grade （MBG）, flow grade of prc-intervention and post-intervention thrombolysis in myocardial infarction （TIMI）, left ventrieular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVSDV）, left ventricular mass （LVW）, left ventricular mass index （LVWI） and left ventricular ejection fraction （LVEF） were evaluated and compared between two groups of patients. Results： There were no significant differences in the post-intervention TIMI flow, LVEDV, LVW or LVWI between two groups （P〉 0.05）. While the ratio of pre-intervention TIMI grade 3 flow, ratio of post-intervention MBG 3 and LVEF were better in NSTEMI group than those of STEMI group （P 〈 0.05 or P 〈 0.01）. Conclusion： The myocardial reperfusion and left ventricular function were better in NSTEMI patients undergoing early coronary intervention than those of patients with STEMI.