急性心肌梗死不同时间窗急诊经皮技巧.docVIP

急性心肌梗死介入 陆德 葛智儒 龚佩华 王海容 窦桂珍(邮编200135) 上海交通大学医学院附属瑞金医院心脏科 沈卫峰 张奇(邮编200025) 【摘要】 目的 评价急性心肌梗死患者介入治疗时间预后的关系。 2004年1月至200年9月确诊且行急诊患者15例，根据第一次球囊扩张的时间间隔分为A组6小时内B组6-12小时左室射血分数、心脏主要不良事件。A组 (P0.05),与B组比较，A组左室心脏主要不良事件发生率 (P0.05)。 of different treatment times on prognosis of Primary percutaneous Coronary Intervention for acute myocardial infarction LIN Jie，QIU Jianping，LU Jide，GE Zhiru，GONG Peihua， WANG Hairong，DOU Guizhen (Department of Cardiology , Shanghai Pudong Gongli Hospital , Shanghai 200135 , China) 【A】Objective: evaluate the impact of different treatment times on prognosis of Primary percutaneous Coronary Intervention for acute myocardial infarction. Methods: A totle of 153 AMI patients were enrolled from January 2004 to September 2006 and followed up for a. year. According to the Symptom-onset-to-ballon time, the patients were categorized into:≤6 hours（group A）and6∽≤12 hours (group B). Results: There was a similar clinical and coronary characteristic between two groups.All showed statistically insignificant. There were no differences in in-hospital and 1-year mortality by time to reperfusion(in-hospital mortality:3.57％ vs 4.87% P0.05; 1-year mortality: 1.78％ vs 2.43% P0.05). Earlier reperfusion（≤6 hours vs 6∽≤12 hours)was associated with less total main adverse cardiac events (MACE)(10.71％ vs 24.39％, P 0.05), more frequent complete ST-segment resolution(68.75％ vs 51.22％％, P 0.05); and greater improvement in left ventricular function. Conclusions: Direct PCI ≤6h after onset of symptoms results in significantly reduce total MACE，enhanced microvadcular reperfusion，and better recovery of left ventricular function. 【KEY WORDS】myocardial infarction; primary percutaneous coronary intervention; prognosis. 急性心肌梗死（acute myocardial infarction，AMI）患者急诊经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）的时间对预后的影响目前尚无一致结论。本研究旨在评价行急诊PCI的时间对AMI患者左室功能恢复、心脏主要不良事件发生等临床预后的意义。 资料和方法 1.临床资料 回顾性分析我院2004年1月至200年月根据起病时间和第一次球囊扩张时间的间隔分为6小时内（A组）和6-12小时（B组）两组(IABP)术。对经冠状动脉成形术后冠状动脉痉挛