急性心肌梗死合并多支血管病变患者非梗死相关动脉处理的时机

发布时间：2018-02-06 01:04

本文关键词： 心肌梗死多支血管病变非梗死相关动脉经皮冠状动脉预后　出处：《山东大学学报(医学版)》2016年08期 　论文类型：期刊论文

【摘要】：目的探讨急性心肌梗死(AMI)合并多支血管病变(MVD)患者经皮冠状动脉介入治疗(PCI)开通非梗死相关动脉(Non-IRA)的最佳时机。方法纳入AMI合并MVD患者357例,根据是否干预及干预Non-IRA的时机分为对照组(只干预罪犯血管且未择期开通Non-IRA)(n=117)、MV-PCI组(急诊PCI同时开通Non-IRA)(n=32)、0~7 d组(n=28)(排除MV-PCI患者)、8~30 d组(n=84)、31~60 d组(n=96),随访2年。比较各组基本临床资料、冠脉造影\PCI情况和2年内主要心血管不良事件(MACE)等。结果院内MACE发生率对照组最低(3.4%),其次为31~60 d组(4.2%),MV-PCI组最高(18.8%)(P=0.02)。随访MACE发生率对照组最高(59.8%)(P0.01)。累积MACE发生率31~60 d组最低(18.80%)(P0.01)。结论 PCI干预非梗死相关动脉能够改善预后;急诊PCI一次性完全血运重建风险较大;心肌梗死后31~60 d为干预AMI患者非梗死相关动脉的较理想时机。
[Abstract]:Objective to investigate the percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) complicated with multiple vessel disease (MVD). Methods 357 AMI patients with MVD were included. According to whether or not to intervene and the timing of intervention in Non-IRA were divided into control group (only intervention in the blood vessels of criminals and unselected opening of Non-IRAA nu 117). In MV-PCI group (emergency PCI was opened at the same time, Non-IRAA ~ (32) D group 7 d) (excluding MV-PCI patients). The patients were followed up for 2 years. The basic clinical data of each group were compared. Results the incidence of MACE was the lowest in the control group (3.4%). The second was 31D 60 d group (4.2%). The highest incidence of MACE in the MV-PCI group was 18.8% and the highest incidence of MACE was 59.8% in the control group (P 0.01). The cumulative incidence of MACE was the lowest in the 31d 60 d group. Conclusion PCI intervention in non-infarct related arteries can improve the prognosis. The risk of complete revascularization in emergency PCI was higher. Thirty-one days after myocardial infarction was an ideal time to intervene non-infarct related arteries in patients with AMI.
【作者单位】：山东大学附属省立医院心血管科;
【分类号】：R542.22

【相似文献】