高血栓负荷的急性心肌梗死患者开通罪犯血管后延迟支架置入的临床效果被引量：5

导出

摘要目的探讨高血栓负荷的急性心肌梗死(AMI)患者在开通罪犯血管后延迟支架置入的临床效果。方法回顾性分析该院行经皮冠状动脉介入治疗(PCI)的AMI患者,选择高血栓负荷病变患者86例,即时支架组(34例)经PCI和(或)血栓抽吸开通罪犯血管后,立即置入支架。延迟置入支架组(52例)未立即置入支架,7~14 d复查冠脉造影,根据病变血管的狭窄情况决定是否置入支架。观察两组PCI情况及主要心血管事件(MACE)发生率。结果延迟支架组无复流的发生率显著低于即时支架组(P<0.05);延迟支架组置入支架者明显低于即时支架组(P<0.05);延迟支架组置入支架的直径显著大于即时支架组(P<0.01),置入支架的长度明显小于即时支架组(P<0.05)。院内和1年的MACE发生率延迟支架组显著少于即时支架组(P<0.05)。结论高血栓负荷的AMI患者在开通罪犯血管后,充分抗栓药物治疗,延迟支架置入,可减少无复流,改善心肌灌注,减少MACE事件,改善预后;同时也能降低支架的置入率,更能正确选择支架的直径和长度,优化心肌梗死的PCI治疗。

作者安佰富张广成张雪莲刘和平

机构地区吉林省人民医院心内科

出处《中国老年学杂志》 CAS 北大核心 2017年第20期5031-5032,共2页 Chinese Journal of Gerontology

关键词血栓心肌梗死延迟支架置入

分类号 R54 [医药卫生—心血管疾病]

引文网络
相关文献

参考文献1

1罗新林,刘强,王丽丽,翁建新,左辉华,魏熠,曹茜.延期支架置入对高血栓负荷ST段抬高急性心肌梗死预后的影响[J].中国介入心脏病学杂志,2014,22(11):697-701. 被引量：10

二级参考文献21

1Steg PG, James SK, Atar D, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J, 2012, 33 : 2569-2619.
2O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation /American Heart Association Task Force on Practice Guidelines. Circulation, 2013, 127: 529-555.
3Vlaar PJ, Svilaas T, van der Horst IC, et al. Cardiac death and reinfarction after 1 year in the Thrombus Aspiration during Pereutaneous coronary interventionin Acute myocardial infarction Study (TAPAS) : a 1-year follow-up study. Lancet, 2008, 371 : 1915-1920.
4Henriques JP, Zijlstra F, Ottervanger JP, et al. Incidence and clinical significance of distal embolization during primary angioplasty for acute myocardial infarction. Eur Heart J, 2002, 23:1112-1117.
5van't Hof AW, Liem A, Suryapranata H, et al. Angiographic assessment of myocardial rcperfusion in patients treated with primary angioplasty for acute myocardial infarction: myocardial blush grade. Zwolle Myocardial Infarction Study Group. Circulation, 1998, 97:2302-2306.
6Burzotta F,Trani C, Romagnoli E, et al. A pilot study with a new, rapid-exchange, thmmbus-aspirating device in patients with thrombus-containing lesions: the Diver C. E. study. Catheter Cardiovasc Interv, 2006, 67: 887-893.
7Wiviott SD, Amman EM, Gibson CM, et al. Evaluation of prasugrel compared with clopidogrel in patients with acute coronary syndromes: design and rationale for the TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet Inhibitio N with prasugrel Thrombolysis In Myocardial Infarction 38(TRITON-TIMI38). Am Heart J, 2006, 152:627-635.
8Amman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction-executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1999 guidelines for the management of patients with acute myocardial infarction). J Am Coll Cardiol, 2004, 44:671-719.
9Jaster M, Schwimmbeck P, Spensker S, et al. Randomized comparison of platelet-leukocyte aggregates and platelet activation in blood: heparin-coatedcoiled wire stent implantation versus balloon angioplasty in acute myocardial infarction. Thromb Res, 2003, 112:285-289.
10Wilson SH, Berger PB, Mathew V, et al. Immediate and late outcomes after direct stent implantation without balloon predilatation. J Am Coil Cardiol, 2000, 35:937-943.