摘要
目的分析经皮冠状动脉介入治疗(PCI)相关性心肌梗死的危险因素。方法选择行择期PCI的患者275例,男性228例(82.9%),女性47例(17.1%),平均年龄(62±9)岁,其中162例(58.9%)患者被诊断为急性冠脉综合征(ACS)。检测患者术后8~12h肌钙蛋白I(cTnI)水平,并依据2007年美国AHA关于PCI相关性心梗的诊断标准将患者分成两组(围术期心肌梗死组和非围术期心肌梗死组),观察两组患者术前临床特征、造影结果、术中相关并发症等与PCI围术期相关性心梗之间的关系。结果19例(6.91%)患者发生围术期心肌梗死。造影结果提示,冠脉多支病变(2,3比1)、血栓病变及术中相关并发症(限制性血管夹层、边支血管闭塞、无复流现象)与PCI围术期心肌梗死发生密切相关(P〈0.05)。结论①冠脉多支病变患者发生围术期心肌梗死的概率高于单支病变患者;②冠脉存在血栓病变易发生围术期心肌梗死;③术中相关并发症的发生与围术期心肌梗死密切相关。
Objective To analyze risk factors of PCI (percutaneous coronary intervention) related myocar- dial infarction and to better guide the clinical treatment. Methods A total of 275 patients undergoing elective PCI were enrolled, including 228 male (82.9%) and 47 female (17.1%). The average age of patients was (62-9), and 162 cases (58.9%) patients were diagnosed acute coronary syndrome (ACS). Troponin I(cTnI) was measured 8- 12 h after the intervention, and all the subjects are divided into 2 groups (periprocedural myocardial infarction group vs non-periprocedural myocardial infarction group), according to 2007 AHA diagnostic criteria for PCI-ro- lated myocardial infarction. The correlation of clinical features, angiography, operation-related complications and other factors before PCI and perioperative myocardial infarction were observed between the two groups. Results There are 19 cases (6.91%) with perioperative myocardial infarction. Angiographic results suggested coronary mul- tivessel disease (2,3 vs 1 ), thrombotic lesions and operation-related complications(restrictive vessel dissection, side branch flow occlusion, no-roflow phenomenon) were closely associated with the occurrence of PCI perioperative my- ocardial infarction (P〈0.05). Conclusion The occurrence of perioperative myocardial infarction in patients with coronary muhivessel disease is more frequent than that of those with single vessel disease. Coronary thrombosis le- sions tend to induce perioperative myocardial infarction, the occurrence of operation-related complications is also closely related to periprocedural myocardial infarction.
出处
《中国心血管病研究》
CAS
2013年第6期409-412,共4页
Chinese Journal of Cardiovascular Research
关键词
经皮冠状动脉介入治疗
心肌梗死
危险因素
Percutaneous coronary intervention
Myocardial infarction
Risk factors