摘要
目的观察心肌梗死病史对冠状动脉慢性完全闭塞病变（CTO）患者介入治疗的影响。方法对87例行选择性冠状动脉造影示CTO并接受介入治疗患者的临床资料进行回顾性分析，根据病史及临床资料分为有陈旧心肌梗死病史组及无心肌梗死病史组，观察2组患者的临床、造影基本资料及即刻介入手术成功率、入院期间严重心血管事件的发生率。结果无心肌梗死病史组即刻介入手术成功率为83．6％，有陈旧心肌梗死病史组为59．3％，两者比较差异有统计学意义（P=0．012）；有心肌梗死病史组除心功能不全者较多外（25％与5％，P=0．008），年龄、性别、易患因素等方面均无明显差异，造影资料显示2组病变血管组成（病变血管数目、闭塞血管位置）无明显差异。有陈旧心肌梗死组病变多表现为“突然型”闭塞，提示造成介入治疗成功率不同的原因与病变的病理组成有关。结论有心肌梗死病史者的CTO介入治疗成功率低，与血管闭塞形态有关，了解病史可以指导合理地选择导丝以增加冠状动脉介入治疗的成功率。
Objective To investigate the impacts of chronic total occlusion （CTO）in patients with previous myocardial infarction on outcomes of percutaneous intervention （PCI）. Methods The clinical data of 87 cases with the CTO lesions undergoing coronary intervention were retrospectively analyzed. The lesion was classified into groups with/without pervious MI history according to the medical history and clinical data. Clinical, angiographic data and immediate PCI success rate,major adverse cardiac event （MACE） were compared. Results Immediate PCI success rate was 59.3% in previous MI group and 83.6% in non-previous MI group （ P = 0. 012 ）. There were no differences in age, sex and risk factors between these two groups, however in comparison with non previous MI group, there were more patients with impaired ejection function in previous MI group（25% vs 5% P =0.008 ）. The angiographic findings indicated the differences of successful PCI rate lied in the different histopathology resulted from different occlusion history. Conclusion PCI of CTO from previous myocardial infarction has a lower immediate procedure success rate, which is associated with morphology of the occluded artery, and to know well of the condition can contribute to wisely selecting guide wire ,which can enhance the success rate of intervention.
出处
《中国综合临床》
北大核心
2008年第3期199-201,共3页
Clinical Medicine of China
基金
北京市优秀人才培养专项基金资助（2004200300623）
关键词
冠状动脉完全闭塞病变
心肌梗死
冠状动脉介入术
Coronary total occlusion
Myocardial infarction
Pereutaneous coronary intervention
