摘要
目的:探讨使用非顺应性球囊行后扩张(post-dilatation,PD)治疗在低血栓负荷的急性ST段抬高型心肌梗死(ST-segment elevation acute myocardial infarction,STEMI)合并2型糖尿病(type 2 diabetes mellitus,T2DM)患者行急诊冠状动脉介入治疗(percutaneous coronary intervention,PCI)的临床疗效和安全性。方法:连续选取2016年1月至2021年12月因STEMI合并T2DM在我院行急诊PCI的患者122例,根据是否在PCI后行PD治疗分为PD组(n=78)及非PD组(n=44),比较两组的临床资料、手术情况、术后TIMI血流、术后ST段抬高指数回落(∑STIR)情况、住院期间主要心脏不良事件(MACE)的发生率以及PCI术后一年LVEF、支架内再狭窄和MACE发生率。结果:与非PD组相比,PD组住院期间MACE发生率(15.9%比3.8%)、PCI术后一年的支架内再狭窄(14.3%比2.6%)和MACE发生率(21.4%比2.6%)均显著降低(P<0.05或<0.01),而PCI术后一年的LVEF[58.50(52.75,65.25)%比64.00(58.25,67.50)%]显著升高(P=0.005)。结论:低血栓负荷的STEMI合并T2DM患者在急诊PCI中使用非顺应性球囊行PD治疗安全可行,且可降低住院期间MACE发生率、PCI术后一年的支架内再狭窄和MACE发生率,改善患者左心功能,为此类患者在急诊PCI治疗中使用PD治疗提供了临床参考。
Objective:To explore the clinical therapeutic effect and safety of noncompliant balloon post-dilatation(PD)during emergency percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI)and type 2 diabetes mellitus(T2DM)with low thrombus burden.Methods:A total of 122 STEMI+T2DM patients,who underwent emergency PCI in our hospital from Jan 2016 to Dec 2021,were consecutively enrolled.According to PD therapy after PCI or not,they were divided into PD group(n=78)and non-PD group(n=44).Clinical data,PCI condition,postoperative TIMI blood flow,ST-segment elevation index resolution(∑STIR),incidence rate of the major adverse cardiac events(MACE)during hospital and LVEF,incidence rates of in-stent restenosis and MACE within one year after PCI were compared between two groups.Results:Compared with non-PD group,there were significant reductions in incidence rate of MACE during hospital(15.9%vs.3.8%),incidence rates of in-stent restenosis(14.3%vs.2.6%)and MACE within one year after PCI(21.4%vs.2.6%)in PD group(P<0.05 or<0.01),there were significant rise in LVEF within one year after PCI[58.50(52.75,65.25)%vs.64.00(58.25,67.50)%]in PD group(P=0.005).Conclusion:It's safe and feasible to apply noncompliant balloon PD during emergency PCI in STEMI+T2DM patients with low thrombus burden.It can reduce incidence rate of MACE during hospital,in-stent restenosis and MACE within one year after PCI,and improve left heart function of patients,and provide clinical reference for the use of PD therapy in emergency PCI for these patients.
作者
郝荣
王大杰
赵秋实
HAO Rong;WANG Da-jie;ZHAO Qiu-shi(Department of Cardiology,Third People′s Hospital of Yancheng City,Yancheng,Jiangsu,224005,China)
出处
《心血管康复医学杂志》
CAS
2024年第1期84-89,共6页
Chinese Journal of Cardiovascular Rehabilitation Medicine
基金
2020年盐城市医学科技发展计划项目(YK2020069)。
关键词
心肌梗死
糖尿病
2型
血管成形术
气囊
冠状动脉
Myocardial infarction
Diabetes mellitus,type 2
Angioplasty,balloon,coronary
