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ID:27565725
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时间:2018-12-04
《不同血管的急性下壁心肌梗死老年患者直接pci术后短期预后分析》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、不同血管的急性下壁心肌梗死老年患者直接PCI术后短期预后分析[摘要]目的探讨急性下壁ST段抬高型心肌梗死行直接经皮冠状动脉介入治疗的老年患者,不同罪犯血管对短期临床预后的影响。方法选择2015年1月〜2016年4月徐州医科大学附属医院心内科行pPCl的下壁STEMI并成功开通靶血管的老年患者133例。根据IRA不同将患者分为右冠状动脉组和左回旋支组。收集所有入选患者一般临床资料并随访患者术后30d内主要不良心血管事件,包括心源性死亡、心力衰竭/心源性休克、恶性心律失常及靶血管血运重建。结果RCA组术后7d及随访30d后所测得LVEF明显低于LCX组[%比%,%比],差异有统计
2、学意义。RCA组随访期内共出现45例MACE事件,而LCX组MACE事件仅6例,RCA组MACE事件发生率明显高于LCX组,差异有统计学意义。结论IRA为RCA的下壁STEMI老年患者短期临床预后较LCX者差。[关键词]老年患者;下壁心肌梗死;直接经皮冠状动脉介入治疗;罪犯血管;短期预后[中图分类号]R542.22[文献标识码]A[文章编号]1673-721005-0056-04[Abstract]ObjectiveToinvestigatetheelderlypatients’short-termclinicalprognosisofacuteinferiorwallST-
3、segmentelevationmyocardialinfarctionwithdifferentinfarct-relatedarteryundergoingprimarypercutaneouscoronaryintervention.MethodsFromJanuary2015toApril2016,inDepartmentofCardiologyofAffiliatedHospitalofXuzhouMedicalUniversity,133elderlypatientswiththeinferiorwallSTEMIundergoingpPCIsuccessfull
4、ywereselected.AccordingtodifferenceofIRA,theenrolledelderlypatientsweredividedintorightcoronaryarterygroupandleftcircumflexgroup.Thepatients’generalclinicalcharacteristic,andallpatientsfollowedupwithin30dofmajoradversecardiovascularevents,includingcardiacdeath,heartfailureorcardiogenicshock
5、,malignantarrhythmiaandtargetvesselrevascularizationwerecollected.ResultsLVEFofRCAgroupafteroperation7dandfollow-up30dweresignificantlylowerthanthoseofLCXgroup[%vs%,%vs%,],thedifferenceswerestatisticallysignificant.Duringthefollow-upperiod,therewere45MACEcaseinthegroupRCA,only6MACEcasesinth
6、egroupLCX.incidenceofMACEintwogroupswascompared,thedifferencewasstatisticallysignificant.ConclusionRCAinducedinferiorSTEMIinelderlypatientshasapoorershort-termprognosisthanLCX.[Keywords]Elderlypatients;Inferiormyocardialinfarction;Primarypercutaneouscoronaryintervention;Infarct-relatedarter
7、y;Short-termprognosis令s着社会的发展、生活水平的提高,冠心病发病率急剧上升,同时急性下壁ST段抬高型心肌梗死作为冠心病最危急的一种急症,其发病率也随之越来越高。直接经皮冠状动脉介入治疗作为快速、安全、高效开通罪犯血管的一种治疗手段,己被国内外各大指南所推荐[1-4]。既往有文献报道[5],前壁STEMI具有较低的左心室射血分数,且慢性心力衰竭的发生率及累积的心源性死亡率要明显高于下壁STEMI,前壁STEMI患者临床预后较下壁STEMI者差。但下壁STEMI不同IRA的预后如何报道
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