急性冠脉综合征380例急诊介入治疗的短期和长期预后分析.docVIP

急性冠脉综合征380例急诊介入治疗的短期和长期预后分析 　　作者：严松彪 陈晖 贾三庆 王雷 李虹伟 苏淑红 高红丽 王璐 韩炜 　作者单位:100050北京首都医科大学附属北京友谊医院心血管疾病诊治研究中心 　　【摘要】 目的 分析380例急性冠脉综合征患者经急诊介入治疗后的短期和长期预后情况。方法 连续入选我院心血管中心自2000年4月～2004年1月收治的380例行急诊介入治疗的急性冠脉综合征患者，分析他们的临床和造影特点，同时以门诊和电话的方式进行随访，平均随访26.8±12.1个月(6～51个月)，了解预后情况并分析与预后相关的因素。结果 入选患者共380例，其中男283例，女97例，平均年龄60.7±11.5岁(29～88岁)。其中急性前壁心肌梗死184例(48.4%)，急性下壁心肌梗死167例(43.9%)，UAP/NSTEMI29例(7.6%)。这些患者中，行急诊PCI346例(91%)，行择期CABG手术11例(2.9%)，药物保守治疗23例(6.1%)。其中55例进行了溶栓治疗(14.5%)，溶栓90min造影开通31例(56.4%)，溶栓后即刻行PCI者46例(83.6%)。急诊PCI共干预360支血管，成功率95.7%。院内死亡率5.3%，长期随访病死率10%，长期无事件生存率76%。结论 对急性冠脉综合征行急诊介入治疗可以尽早开通梗死相关动脉，恢复前向血流，降低心肌梗死后的临床事件的发生率，缩短住院时间，改善患者的短期和长期预后。 　　关键词 急性冠脉综合征 急诊介入治疗 预后 　　The short-term and long-term prognosis of380patients with acute coronary syndrome underwent emergency percutaneous coronary intervention 　　Yan Songbiao，Chen Hui，Jia Sanqing，et al. 　　HeartBlood Vessel Center，Beijing Friendship Hospital Affiliated to Capital University of Medical Sciences，Beijing100050 　　【Abstract】 Objective To analyze the short-term and long-term prognosis of380patients with acute coronary syndrome(ACS)underwent emergency percutaneous coronary intervention(PCI).Methods 380continuous patients with ACS from Apr2000to Jan2004were enrolled.To analyze the angiographical and clinical features and the follow-up reˉsults of these patients，and the average follow-up time was(26.8±12.1)months(6～51months).Results Of380paˉtients，283cases were male，97cases were female，the average age was(60.7±11.5)years(29～88years)，184cases were acute anterior wall myocardial infarction，167cases were acute inferior wall myocardial infarction，29cases were UAP/NSTEMI.Emergency-PCIwas performed in346cases，CABGwas performed in11cases and the other23cases reˉceived drug treatment.55patients underwent thrombolysis treatment and46patients underwent PCI after thrombolysis.A total of360vessels were interventioned and the success rate was95.7%.In-hospital mortality was5.3%and the long-term mortality was10%and free