急诊PCI治疗高危不稳定性心绞痛临床探究.docVIP

急诊PCI治疗高危不稳定性心绞痛临床探究 　【摘要】 目的：评价急诊PCI治疗高危不稳定性心绞痛的疗效及安全性。方法：78例高危不稳定性心绞痛患者急诊入院后随机分为两组：急诊介入组46例，非急诊介入组32例，两组均行冠脉造影和介入治疗，对比观察30d内心脏事件（包括心绞痛、急性心肌梗死、猝死、再次介入治疗及冠脉搭桥手术）的发生率、症状缓解率、症状缓解时间和住院时间等。结果：急诊介入组与非急诊介入组比较，急诊介入治疗高危不稳定性心绞痛降低了30d内心脏事件（心绞痛、急性心肌梗死、猝死）的发生，plt;0.05；缩短了症状缓解及住院时间，Plt;0.05；而手术的成功率及疗效相似，Pgt;0.05。结论：急诊PCI治疗高危不稳定性心绞痛安全性高，疗效可靠，并可缩短住院时间。 【关键词】 不稳定性心绞痛；冠状动脉介入治疗 　　The Clinical Research of Emergency PCI for High Risk Unstable Angina Pectoris 　　Abstract：Objective：To study the efficacy and safety of emergency percutaneous coronary intervention （PCI） for high risk unstable angina pectoris. Method：78 patients with high risk UAP were randomized divided into two groups: emergent PCI groups, 46 patients; non-emergent PCI groups,32 patients; All the patients were performed coronary angiography and percutaneous coronary intervention. The cardiac events(including angina pectoris, acute myocardial infarction, sudden death, reintervention and coronary artery bridge graft) in 30 days, symptom relief rate, symptom relief time, duration of hospitalization and hospitalization expenditure were recorded. Result：Emergent PCI decreased cardiac event ( angina pectoris, acute myocardial infarction, sudden death) rates in 30 days, Plt;0.05, shortened symptom relief and hospitalization time, Plt;0.05,decreased hospitalization expenditure, Plt;0.05. But the procedural success rates and the efficacy were identical with non-emergent intervention group, Pgt;0.05. Conclusion：Emergent PCI for high risk unstable angina pectoris is effective, safe, and also can shorten hospitalization time. 　　Key words： Unstable angina pectoris; Percutaneous coronary intervention 　　不稳定性心绞痛（unstable angina pectoris，UAP）是介于稳定性心绞痛与急性心肌梗死和猝死之间的一组临床心绞痛综合征。由于其独特的病理生理机制及临床预后，如果不能恰当及时治疗，患者可能发展为急性心肌梗死和猝死，其中高危UAP危害最大。本文通过观察急诊PCI（percutaneous coronary intervention）治疗高危UAP的临床效果，并与经药物强化治疗后非急诊介入治疗高危UAP的临床结果进行对比，旨在评价急诊PCI治疗高危UAP的效果及安全性。 　　1 资料与方法 　　1.1 临床资料：选择我院2005年1月至2006年12月间急诊内科住院治疗的78例高危UAP患者。其中男48例，女30例，平均年龄67.12±12.34（40～