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心肌梗死后闭塞冠状动脉内支架植入疗效分析

Analysis of stenting treatment for occlusive coronary artery after myocardial infarction
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摘要 目的 :探讨心肌梗死 (MI)后再发心肌缺血且闭塞远端已有侧支循环建立病例 ,闭塞冠状动脉 (OCA)内支架植入疗效。方法 :MI后再发心肌缺血行冠脉内支架植入治疗 1 32例 ,冠状动脉造影均见闭塞远端侧支循环建立 ,分为OCA再通组 (A组 )及未通组 (B组 ) ,随访 6~ 1 8个月并进行心绞痛分级 ,测定左室射血分数 (LVEF) ,统计心脏事件。结果 :总手术成功率 95 .4 % ,OCA再通植入支架成功率为 80 .3% ,A组与B组比较 ,平均植入支架数量多 (P <0 .0 1 ) ;心脏事件发生率少 (P <0 .0 1 ) ,心绞痛发作程度减轻 (P <0 .0 1 ) ,LVEF改善 (P <0 .0 1 )。结论 :MI后冠状动脉闭塞 ,远端已有侧支循环建立的病例 ,植入支架可有效缓解心绞痛发作 ,改善左室功能 ,减少心脏事件的发生。 Objective: To evaluate the curative effect of stenting treatment for occlusive coronary artery(OCA) with myocardial ischemia after myocardial infarction(MI) accompanied with collateral circulation formed at occlusion extremity.Methods: Patients(132) underwent stenting treatment were investigated.They all suffered from myocardial ischemia reemerging after MI with collateral circulation at occlusion extremity. The patients were divided into patent coronary artery group ( group A) and occlusive coronary artery group(group B). The follow up lasted for 6 to18 months. Before operation and at the end of follow up, angina pectoris was graded and LVEF was measured. The statistical data on cardiac accident were collected.Results:The general success rate of operations was 95.4%, while the success rate of stenting treatment for OCA was 80.3%.The number of stents transplanted in group A was larger than that in group B(P<0.01). The incidence of cardiac accident in group A was lower during follow up(P<0.01). The extent of angina pectoris decreased(P< 0.01 ),and the level of LVEF improved(P<0.01) in group A at the end of follow up. Conclusion:For patients with myocardial ischemia reemerging after MI with collateral circulation formed at occlusion extremity, transplanting stents can alleviate the outbreak of angina pectoris,improve the functions of left ventricle,and reduce the incidence of cardiac accident.
出处 《中国医科大学学报》 CAS CSCD 北大核心 2004年第3期238-239,242,共3页 Journal of China Medical University
关键词 心肌梗死 侧支循环 闭塞冠状动脉 左室射血分数 myocardial infarction collateral circulation occlusiue coronary artery left ventricular ejection farction
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