天津医药

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不同类型急性心肌梗死早期介入治疗效果的比较

徐建强,卢成志,赵向东,夏大胜,陈欣,于翔   

  1. 天津市第一中心医院
  • 收稿日期:2011-11-21 修回日期:2012-02-06 出版日期:2012-09-15 发布日期:2012-09-15
  • 通讯作者: 徐建强

Comparison of Different Acute Myocardial Infarction Patients Undergoing Early Intervention

  • Received:2011-11-21 Revised:2012-02-06 Published:2012-09-15 Online:2012-09-15
  • Contact: Jian-qiang XU

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摘要： 目的：比较急性非ST段抬高型心肌梗死（NSTEMI）和急性ST段抬高型心肌梗死（STEMI）患者接受早期再灌注治疗后，冠脉血流、心肌灌注及心功能情况的差异。方法：接受早期再灌注治疗的急性心肌梗死患者共168例，分为NSTEMI组（n=55）和STEMI组（n=113），比较两组患者的术后心肌呈色分级（MBG）水平、术前及术后的TIMI血流分级、左室舒张末期容积（LVEDV）、收缩末期容积（LVESV），左室质量(LVW)、左室重量指数（LVMI）及左室射血分数（LVEF）等。结果：NSTEMI组与STEMI组间术后TIMI血流情况、LVEDV、LVW及LVWI之间的差异无统计学意义（P>0.05），但是NSTEMI组的术前TIMI血流3级的比例、术后MBG 3级比例和LVEF明显优于STEMI组（P < 0.05）。结论：NSTEMI患者接受早期介入治疗术后的心肌再灌注情况以及左室收缩功能优于STEMI患者。

关键词: 急性心肌梗死, 经皮冠状动脉介入治疗, 心肌呈色分级, 左室射血分数

Abstract: Objective: To compare the coronary flow, reperfusion of the ischemic myocardium and cardiac function of patients with acute non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI) who received early invasive intervention strategy. Methods: A total of 168 patients with acute myocardial infarction undergoing early coronary intervention were enrolled, including 55 patients in NSTEMI group and 113 patients in STEMI group. The myocardial blush grade (MBG), pre-intervention thrombolysis in myocardial infarction (TIMI) flow, post-intervention TIMI flow, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVSDV), left ventricular mass (LVM) , left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF) were evaluated for comparison. Results: There were no differences of post-intervention TIMI flow, LVEDV, LVW or LVWI between the two groups (P>0.05). While the ratio of pre-intervention TIMI grade 3 flow, ratio of post-intervention MBG 3, and LVEF of NSTEMI group were better than those of STEMI group (P < 0.05). Conclusion: The myocardial reperfusion and left ventricular function of NSTEMI patients were prior to STEMI patients undergoing early coronary intervention.

Key words: acute myocardial infarction, percutaneous coronary intervention, myocardial blush grade, left ventricular ejection fraction