介入治疗对急性冠脉综合征患者近期疗效的观察-心血管内科专业论文.docxVIP

山阿陌利人学 山阿陌利人学 2003肺坝I‘Ⅲ究生学位论义 介入治疗对急性冠脉综合征患者 近期疗效的观察 研究生张军 导师吕吉元 摘 要 目的 应用99“Tc—MIBI心肌灌注断层显像随访经皮冠脉介入治疗 (percutaneous coronary intervention，PCI)(包括PTCA及支架置入术)对 急性冠脉综合征(acute coronary syndroms，ACS)的近期疗效。 方法通过运动一静息心肌灌注断层显像检查，观察患者在PTCA及 支架置入术前及随访期间缺血节段数及放射性积分的变化情况。 结果40例患者在术前及术后1月、3月、6月分别进行心肌灌注显 像。结果显示与术前相比，术后缺血节段数减少(1．57±1．42、1．00±I．39、 1．17±1．40、1．23±1．33，P0．05)，放射性异常积分缩小(3．26+3．63、 2．29±3．44、2．54±3．41、2．5l±3．27，PO．05)，说明近期缺血明显改 善。术后1月再缺血者l例，3月再缺血者4例，6月再缺血者6例。 结论 1．成功的PCI可改善心肌向供，减少缺血节段数。2． 99 Tc—MIBI运动一静息(ST—RE)SPECT是评估PCI术后近期疗效的有 效手段。 关键词经皮冠脉介入治疗(PCI)，PTCA及支架置入，急性冠脉综 合征(ACS)：SPECT，MIBI 山西医科大学 山西医科大学 2003届硕士研究生学位论文 Evaluation ofthe recent efficacy ofpercutaneous coronary intervention in patients with acute coronary syndroms Abstract objective To investigate the recent efficacy of percutaneous coronary intervention(PCI)(percutaneous tmsluminal coronary angioplasty and coronary stenting)using SPECT 99 Tc—MIBI myocardial perfusion imaging in patients with acute coronary syndroms(ACS)． Methods The numbers of ischemic segments and the ischemic score were observed by stress-rest 99 Tc—MIBI SPECT myocardial perfusion imaging which were performed on the patients before PCI and during follow-up． Results SPECT imaging were obtained in 40 patients before PCI and 1 month，3 months and 6 months after PCI，respectively．There were significant differencesintheischemic segments(1．57-1-1．42、1．OO±I．39、l_17±I．40、 1．23±1．33，PO．05)andtheischemic score(3．26±3．63、2．29±3．44、2．54 ±3．41、2．51±3．27，PO．05)．compaired beforeand after PCI．It suggested that the recent ischemia was significantly improved．Recurrent isehemia occured in 1 patient(2．5％)I month，4 patients(10％)3 months and 6 patients(15％1 6 months after PCI． Conclusion Successful PCI can improve the myocardial blood supply and decrease the number of ischemic segments．99”Tc—MIBI ST-RE SPECT can provide an efficient value for the evaluation ofthe recent efficacy ofPCI． Key words PCI，PTCA and coronary stenting，ACS；SPECT，MIBI 2 ¨医引人学 ¨医