冠状动脉内支架术治疗急性心肌梗塞(摘要)
作者：许泓渝 陈绍良 段宝祥 耿其吉 查铭凡 刘玲玲 黄进 叶飞
单位：江苏省南京市，南京医科大学附属南京第一医院 心内科(210006)
关键词：
目的 目的：观察冠状动脉内直接支架术治疗急性心肌梗塞是否安全有效。
方法：我院1998年4月～12月26例急性心肌梗塞患者接受直接经皮冠状动脉腔内成形术(PTCA)和支架术。其中2例伴有心源性休克。心源性休克或血液动力学不稳定时同步置入主动脉内气囊泵(IABP)。以标准方法置入支架。治疗成功的指标是：梗塞相关动脉(IRA)残余狭窄<30%及心肌梗塞溶栓治疗临床试验(TIMI)血流3级。观察围手术期心脏事件(死亡、冠状动脉再梗塞、急性或亚急性血栓形成)的发生，术后心电图改变及术后1个月超声心动图示梗塞相关室壁运动情况。心功能分级，记录随访期心脏事件发生情况。
, http://www.100md.com
结果：住院期间心脏事件发生率7.7%(2例死亡)、手术成功率92.3%,术后即刻心电图示IRA相关导联R波振幅明显增高，术后2小时ST段下降≥50%者有20例，术后1个月超声心动图示梗塞相关室壁段未见反向运动或室壁瘤形成。心功能分级在Ⅰ～Ⅱ级者占80.7%,24例存活者中无一例心脏事件发生。
结论：冠状动脉内直接支架术是治疗急性心肌梗塞安全有效的方法，且益于患者的临床预后。
Application of Primary Stent Implantation in Treatment of Acute Myocardial Infarction (Abstract)
Department of Cardiology, Nanjing No 1 Municipal Hospital, Nanjing (210006), Jiangsu
, 百拇医药
Xu Hongyu, Chen Shaoliang, Duan Baoxiang, et al.
Objective: To investigate the safety and efficacy of primary stent implantation in acute myocardial infarction (AMI).
Methods: Twenty-six AMI patients, from April 1998, to December 1998, treated with primary angioplasty and stent implantation. Intra-aortic balloon pumping (IABP) was used to the patients with cardiac shock or unstable blood pressure before the procedure. Procedural success was defined as a residual stenosis <30% and TIMI grade 3 flow. Cardiac events (death, reinfarction or acute and subacute thrombosis) during in-hospital course and follow-up were recorded, as well as the changes of the electrocardiography after the procedure, the movement of IRA related wall measured by echocardiography, and the classification of heart function.
, http://www.100md.com
Results: Cardiac event rate was 7.7% (2 patients died) during in-hospital course. The procedural success rate was 92.3%. R-wave amplitude of IRA relatcd leads was significantly increased after the procedure. The depression of ST segment was presented in 20 patients in 2 hours. No dyskinesia and aneurysm could be found by the echocardiography in 1 month. Heart furction grade 1 and 2 accounted for 80.7%. No more cardiac events happened during the follow-up.
Conclusion: Primary stenting for AMI was safe and exerted a beneficial effect on the prognosis of the patients., 百拇医药
单位：江苏省南京市，南京医科大学附属南京第一医院 心内科(210006)
关键词：
目的 目的：观察冠状动脉内直接支架术治疗急性心肌梗塞是否安全有效。
方法：我院1998年4月～12月26例急性心肌梗塞患者接受直接经皮冠状动脉腔内成形术(PTCA)和支架术。其中2例伴有心源性休克。心源性休克或血液动力学不稳定时同步置入主动脉内气囊泵(IABP)。以标准方法置入支架。治疗成功的指标是：梗塞相关动脉(IRA)残余狭窄<30%及心肌梗塞溶栓治疗临床试验(TIMI)血流3级。观察围手术期心脏事件(死亡、冠状动脉再梗塞、急性或亚急性血栓形成)的发生，术后心电图改变及术后1个月超声心动图示梗塞相关室壁运动情况。心功能分级，记录随访期心脏事件发生情况。
, http://www.100md.com
结果：住院期间心脏事件发生率7.7%(2例死亡)、手术成功率92.3%,术后即刻心电图示IRA相关导联R波振幅明显增高，术后2小时ST段下降≥50%者有20例，术后1个月超声心动图示梗塞相关室壁段未见反向运动或室壁瘤形成。心功能分级在Ⅰ～Ⅱ级者占80.7%,24例存活者中无一例心脏事件发生。
结论：冠状动脉内直接支架术是治疗急性心肌梗塞安全有效的方法，且益于患者的临床预后。
Application of Primary Stent Implantation in Treatment of Acute Myocardial Infarction (Abstract)
Department of Cardiology, Nanjing No 1 Municipal Hospital, Nanjing (210006), Jiangsu
, 百拇医药
Xu Hongyu, Chen Shaoliang, Duan Baoxiang, et al.
Objective: To investigate the safety and efficacy of primary stent implantation in acute myocardial infarction (AMI).
Methods: Twenty-six AMI patients, from April 1998, to December 1998, treated with primary angioplasty and stent implantation. Intra-aortic balloon pumping (IABP) was used to the patients with cardiac shock or unstable blood pressure before the procedure. Procedural success was defined as a residual stenosis <30% and TIMI grade 3 flow. Cardiac events (death, reinfarction or acute and subacute thrombosis) during in-hospital course and follow-up were recorded, as well as the changes of the electrocardiography after the procedure, the movement of IRA related wall measured by echocardiography, and the classification of heart function.
, http://www.100md.com
Results: Cardiac event rate was 7.7% (2 patients died) during in-hospital course. The procedural success rate was 92.3%. R-wave amplitude of IRA relatcd leads was significantly increased after the procedure. The depression of ST segment was presented in 20 patients in 2 hours. No dyskinesia and aneurysm could be found by the echocardiography in 1 month. Heart furction grade 1 and 2 accounted for 80.7%. No more cardiac events happened during the follow-up.
Conclusion: Primary stenting for AMI was safe and exerted a beneficial effect on the prognosis of the patients., 百拇医药