介入治疗对非ST段抬高型急性冠脉综合征患者心功能的影响-内科学专业论文.docxVIP

PAGE PAGE 2 认，介入治疗的手术数量逐年上升。与内科药物保守疗法相比，PCI 能解除冠脉狭 窄，恢复心肌血供，改善患者心功能，使患者的活动耐力增加，生活质量明显提 高。随着新技术的出现，尤其是新型支架及新型抗血小板药物的应用，PCI 的适应 证也从早期的简单单支病变扩展为更复杂的病变，如多支血管病变、慢性完全闭 塞病变及左主干病变等。PCI 可以明显降低 NSTE-ACS 心肌梗死的发生率和死亡 率,改善患者心功能，提高患者生活质量。经皮冠状动脉介入治疗（PCI）可以开通 狭窄或闭塞的冠状动脉，是缺血心肌得到再灌注，缩小梗死范围，对非 ST 段抬高 型急性冠脉综合征患者心功能改善有很大益处，降低高危患者死亡或发生心肌梗 死的风险，减少抗心绞痛药物的使用、缩短住院时间、降低再次住院率。 【关键词】非 ST 段抬高型急性冠脉综合征；介入治疗；心功能 The effect of interventional strategy on patients with non-ST segment elevation acute coronary syndrome Abstract Non-ST segment elevation acute coronary syndrome is a kind of clinical syndrome. It has pathological characteristics of atherosclerotic plaque rupture of coronary artery, secondary thrombus, and vasospasm. These may cause acute or subacute myocardial ischemia. Non-ST segment elevation acute coronary syndrome includes unstable angina pectoris and non-ST segment elevation myocardial infarction. The emphasis of treatment is to open “culprit vessel”, to recover effective blood perfusion, and to save the myocardium which lacks blood and is nearly necrotic. Moreover, it can control the initial factor—unstable atherosclerotic plaque and make it tend to be stable. Clinical manifestation of NSTE-ACS patient is mainly determined by: ? severity of coronary artery disease ? size and type of thrombus ? time and degree of ischemia ④quantity of myocardial necrosis. Myocardial ischemia degree of NSTE-ACS patient is determined by ? blood-supply range of coronary arteries ? severity of hemadostenosis?whether there is collateral circulation or not④myocardium’s demands on oxygen because of the changes of heart rate, blood pressure and myocardial contractility. Pathological anatomy shows that coronary arteries of NSTE-ACS patient often have many pathological changes. Lumen is not fully closed or collateral circulation is formed. Lateral thrombus is mainly white thrombus, which mainly includes soterocyte. Coronary artery blood vessels of patient may be caused stenosis of different degrees because