紧急冠状动脉内支架术治疗不稳定性心绞痛

Emergent coronary stenting for unstable angina

目的 观察冠状动脉内支架术治疗不稳定性心绞痛 (UA)的疗效和安全性。方法 5 5例UA患者于入院后随机分组为 48h内 (2 9例 ;紧急介入组 )或 7～ 10d后 (2 6例 ;延迟介入组 )行冠状动脉造影及支架术。观察两组手术成功率、心绞痛缓解时间、住院时间和 30d总心脏事件发生率。结果 紧急介入组手术成功率与延迟介入组相似 (93%和 96 % ) ,但心绞痛缓解时间分别为 (4 4±3 1)d和 (5 7± 2 9)d ,P <0 0 5 ;住院时间分别为 (8 8± 3 2 )d和 (13 5± 3 1)d ,P <0 0 5 ,前组比后组明显缩短。紧急介入组 30d总心脏事件发生率较延迟介入组明显减少 (0 %和 19 2 % ,P <0 0 5 )。结论 冠状动脉内支架术治疗UA疗效明显 ,且并发症较少。

Objective To assess the efficacy and safety of intracoronary stenting in acute phase of unstable angina pectoris (UA). Methods Fifty five patients with UA were randomized to emergent interventional group ( n = 29) and delayed interventional group ( n = 26). Coronary angiography and stenting were performed within 48 hours after admission in the former group and 7-10 days later in the latter group. Procedural success rate, time interval between admission and angina relief, and duration of hospital stay were recorded, and cardiac events in 30 days were observed. Results The procedural success rates for emergent group and delayed group were similar (93% versus 96%), but cardiac event rate in 30 days was significantly lower in the emergent group than in delayed group (0% versus 9 2%, P < 0 05). The time interval between admission and angina relief [(4 4±3 1) days versus (5 7±2 9) days] and duration of hospitalization [(8 8±3 2) daysversus (13 5±3 1) days] were significantly reduced in the emergent group (all P < 0 05). Conclusion Coronary stent implantation is effective and safe in acute phase of UA.