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目的：研究急性心肌梗塞（ＡＭＩ）时原发冠状动脉内支架植入术的临床疗效。方法：以标准方法对３０例ＡＭＩ患者行心肌梗塞相关动脉原发冠状动脉内支架植入术。手术成功标准为残余狭窄＜３０％、心肌梗塞溶栓治疗临床试验（ＴＩＭＩ）２或３级血流，且围术期无心脏事件（死亡、冠状动脉再梗塞和心力衰竭）发生。用二维超声心动图测定左心室射血分数。记录随访期心脏事件发生情况。结果：手术成功率为９３．３％，心肌梗塞相关动脉残余狭窄程度为（５．２±６．４）％。住院期间心脏事件发生率为６．７％。随访期中（平均７．１±２．５个月），左心室射血分数较入院时测值显著增高（０．５６±０．０９比０．４７±０．０８，Ｐ＜０．０１），２９例存活者中２８例无心脏事件发生。１２例行冠状动脉造影复查（平均３．１个月），均示心肌梗塞相关动脉通畅，且残余狭窄程度无显著变化［（４．６±７．５）％和（６．２±９．４）％］。结论：ＡＭＩ时原发冠状动脉内支架植入术安全可行，且有益于患者的临床预后。
Objective: To study the clinical effect of primary coronary stenting in acute myocardial infarction (AMI). Methods: Thirty patients with AMI underwent primary coronary stenting with myocardial infarction. Surgical success criteria were residual stenosis <30%, TIMI grade 2 or 3 blood flow, and no perioperative cardiac events (death, coronary re-infarction, and heart failure) occurred. Left ventricular ejection fraction measured by two-dimensional echocardiography. Record the follow-up of cardiac events. Results: The success rate of operation was 93.3%, and the degree of residual stenosis of myocardial infarction related artery was (5.2 ± 6.4)%. The incidence of cardiac events during hospitalization was 6.7%. During the follow-up period (average 7.1 ± 2.5 months), left ventricular ejection fraction was significantly higher than that at admission (0.56 ± 0.09 vs. 0.47 ± 0.08, P <0.01) Of the 29 survivors, 28 had no cardiac events. Twelve patients underwent coronary angiography (mean, 3.1 months). All showed myocardial infarction-related arteries with no significant changes in residual stenosis [(4.6 ± 7.5)% vs (6.2 ± 9) 4)%]. Conclusions: Primary intracoronary stent implantation is safe and feasible in AMI and is beneficial to the clinical prognosis of patients.