稳定性心绞痛患者PCI术中无球囊预扩张直接植入支架对冠脉微循环功能的影响

Effect of Non Pre-dilation and Direct implantation of Stent on Coronary Microcirculation Function in Patients with Stable Angina Pectoris Undergoing PCI

【目的】探讨经皮冠状动脉介入术（PCI）支架植入前球囊预扩张对围手术期冠脉微循环功能损伤的影响。【方法】选择本院收治的40例稳定性心绞痛并拟行择期PCI的患者（加拿大心脏病学会的劳力型心绞痛分级〈Ⅳ级），随机分为支架植入前无球囊预扩张组（未预扩张组，n=20）和支架植入行前球囊预扩张组（预扩张组，n=20）。PCI术后，以压力导丝检测两组入选患者的冠状动脉微循环阻力指数（IMR），对比两组PCI术后IMR差异。【结果】非预扩张组PCI术后IMR值显著低于预扩张组，差异具有统计学意义（P〈0．001）；PCI术后，IMR≥22非预扩张组患者所占比例显著低于预扩张组患者（P〈0．05）。【结论】PCI术中，不行球囊预扩张而植入支架可减少PCI术围手术期冠脉微循环功能损伤。

[Objective]To investigate the effect of percutaneous coronary intervention （PCI） on the function of coronary microcirculation in patients with coronary microcirculation during perioperative period.[Methodl Forty patients with stable angina （Canadian Cardiovascular Society class Ⅳ） in our hospital were selected and admitted for elective percutaneous coronary intervention （PCI）, They were randomized to the non pre-dilation group（ n=20） and the pre-dilation group （ n =20）. After PCI, the index of microcirculatory resistance（IMR） of the two groups was detected by sensor-tipped guide wire, and the difference of IMR between the two groups after surguery was compared with .[Result]After PCI , IMR value of the non pre-dilation group was significantly lower than that in the pre-dilation group, the difference had statistical significance （ P 〈0.001） ;after PCI, IMR was more than or equal to 22, the proportion of the non pre-dilation group was significantly lower than that of the pre-dilation group （ P〈0.05）.[Conclusions] In PCI operation, it can reduce the damage of the coronary microcirculation in the perioperative period by the implantation of the stent without predilation.