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目的:分析急性心肌梗死(AMI)的急诊冠状动脉造影结果,观察经皮冠状动脉腔内成形术(PTCA)或PTCA+支架治疗AMI的近期疗效。方法:将符合条件的AMI患者100例行急诊冠状动脉造影,明确梗死相关血管(IRA),对TIMI血流O～I级的86例患者行直接PTCA或PTCA+支架,观察住院期间死亡率,心脏急性事件发生及并发症。结果:100例患者中单支血管病变19例(19%),双支血管病变27例(27%),三支血管病变47例(47%),左主干病变7例(7%),有侧支循环32例(32%),有钙化43例(43%)。IRA共113支,其中前降支50支,回旋支11支,右冠状动脉52支。15支IRA TIMI血流Ⅲ级未干预,对98支IRA行PTCA或PTCA+支架,7例仅行PTCA,全部获得再通;91支PTCA+支架中88支获得完全再通,前向血流TIMI Ⅲ级,成功率96.9%。PTCA或PTCA+支架成功组住院期间无死亡发生,4例(4.8%)有不稳定心绞痛发生。未行PTCA或PTCA不成功组2例死亡(11.8%),12例有不稳定性心绞痛发生(70.5%)。两组相比差异具有显著性(P<0.05)。结论:急诊PTCA成功率高,住院期间并发症少,心脏急性事件发生少。
OBJECTIVE: To analyze the results of emergency coronary angiography in patients with acute myocardial infarction (AMI) and observe the short-term efficacy of percutaneous transluminal coronary angioplasty (PTCA) or PTCA + stent in the treatment of AMI. Methods: A total of 100 patients with acute myocardial infarction (AMI) undergoing emergency coronary angiography were enrolled in this study. Infarct-related vessels (IRA) were identified. Direct PTCA or PTCA + stents were performed on 86 patients with OI grade TIMI. The mortality, heart rate Acute events and complications. Results: Of the 100 patients, 19 (19%) had single vessel disease, 27 (27%) had double vessel disease, 47 (47%) had three vessel disease, and 7 (7%) had left main disease Collateral circulation in 32 cases (32%), 43 cases of calcification (43%). IRA total of 113, of which 50 cases of anterior descending artery, supination, 11, 52 right coronary artery. Fifteen IRA TIMI blood flow grade Ⅲ were not intervened. For 98 IRA patients, PTCA or PTCA + scaffolds were performed, and only 7 PTCA patients were recaptured. All of the 91 PTCA + scaffolds received recanalization, and the antegrade blood flow TIMI Ⅲ Level, the success rate of 96.9%. In the PTCA or PTCA + stent group, no death occurred during hospitalization, and unstable angina occurred in 4 patients (4.8%). Two patients died (11.8%) without PTCA or PTCA, and 12 patients had unstable angina (70.5%). The difference between the two groups was significant (P <0.05). Conclusion: The success rate of emergency PTCA is high, less complications during hospitalization and fewer acute cardiac events.