本文關(guān)鍵詞：冠狀動(dòng)脈側(cè)枝循環(huán)形成對(duì)急性心肌梗死患者行急診PCI術(shù)預(yù)后的影響　出處：《福建醫(yī)科大學(xué)》2014年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 冠狀動(dòng)脈側(cè)枝循環(huán) 急診PCI術(shù) 急性心肌梗死 主要不良心血管事件 近期預(yù)后

【摘要】：目的探討冠狀動(dòng)脈側(cè)枝循環(huán)（Coronary collateral circulation，CCC）對(duì)急性心肌梗死（Acute myocardial infarction，AMI）患者行急診經(jīng)皮冠狀動(dòng)脈介入治療（Percutaneous coronary intervention，PCI）預(yù)后的影響。 方法選擇107例確診為AMI并行急診PCI術(shù)的患者，根據(jù)術(shù)中冠脈造影結(jié)果，按側(cè)枝循環(huán)的有無(wú)分為側(cè)枝循環(huán)組和非側(cè)枝循環(huán)組，記錄兩組患者相關(guān)臨床信息。對(duì)兩組患者平均隨訪6-10（8.9±1.8）月，觀察其隨訪期間主要不良心血管事件（Major adverse cardiovascular events，MACE）、氨基末端B型腦鈉肽前體（N-terminal Pro-Brain Natriuretic Peptide，NT-proBNP）、左室射血分?jǐn)?shù)（Left ventricular ejection fraction，LVEF）、Gensini積分、心絞痛病史、進(jìn)門(mén)至球囊擴(kuò)張（Door-to-Balloon，D2B）時(shí)間等臨床數(shù)據(jù)進(jìn)行了對(duì)比分析，以綜合評(píng)價(jià)側(cè)枝循環(huán)對(duì)患者預(yù)后的影響。 結(jié)果側(cè)枝循環(huán)組術(shù)后NT-proBNP水平明顯低于非側(cè)枝循環(huán)組，差異有統(tǒng)計(jì)學(xué)意義（P=0.048）。側(cè)枝循環(huán)組術(shù)前和術(shù)后LVEF水平高于非側(cè)枝循環(huán)組，差異有統(tǒng)計(jì)學(xué)意義（P=0.043、P=0.042）。側(cè)枝循環(huán)組Gensini積分水平高于非側(cè)枝循環(huán)組，差異有統(tǒng)計(jì)學(xué)意義（P=0.034）。側(cè)枝循環(huán)組心絞痛病史天數(shù)多于非側(cè)枝循環(huán)組，差異有統(tǒng)計(jì)學(xué)意義（P=0.023）。側(cè)枝循環(huán)組近期MACE發(fā)生比例與非側(cè)枝循環(huán)組比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P=0.299）。 結(jié)論對(duì)于患有AMI行急診PCI術(shù)的病人而言，側(cè)枝循環(huán)的形成可明顯改善冠脈血供，減少梗死面積；側(cè)枝循環(huán)組病人的心絞痛病史較長(zhǎng)，冠脈病變較重，但是由于側(cè)枝循環(huán)的存在，，其術(shù)后LVEF、NT-proBNP較無(wú)側(cè)枝循環(huán)組好，說(shuō)明側(cè)枝循環(huán)對(duì)于心肌缺血的病人起保護(hù)作用，但近期MACE發(fā)生比例與無(wú)側(cè)枝循環(huán)的、冠脈病變輕的患者相比兩者沒(méi)有區(qū)別。
[Abstract]:Objective to investigate the coronary collateral circulation of coronary artery collateral circulation. CCCs were used to treat acute myocardial infarction in patients with acute myocardial infarction. Acute percutaneous coronary intervention (PCI) was performed in patients with acute coronary artery disease (AMI). Methods according to the results of coronary angiography, 107 patients diagnosed as AMI and emergency PCI were divided into collateral circulation group and non-collateral circulation group according to the results of coronary angiography. The patients in both groups were followed up for an average of 6-108.9 鹵1.8 months. Major adverse cardiovascular events were observed during follow-up. N-terminal Pro-Brain Natriuretic peptide NT-proBNPs. Left ventricular ejection fraction (LVEF) and left ventricular ejection fractionator Gensini score, history of angina pectoris. In order to evaluate the influence of collateral circulation on the prognosis of patients, the clinical data such as door-to-Balloonus D2B time from entrance to balloon dilatation were compared and analyzed. Results the level of NT-proBNP in collateral circulation group was significantly lower than that in non-collateral circulation group. The level of LVEF in the lateral branch circulation group was higher than that in the non-lateral branch circulation group before and after operation, and the difference was statistically significant (P 0.043). The Gensini integral level of lateral branch circulation group was higher than that of non-lateral branch circulation group. The difference was statistically significant (P < 0.034). The number of days of angina pectoris history in collateral circulation group was longer than that in non-lateral branch circulation group. There was no significant difference in the incidence rate of MACE between the lateral branch circulation group and the non-lateral branch circulation group. There was no significant difference in the incidence of MACE between the lateral branch circulation group and the non-lateral branch circulation group. Conclusion for patients with AMI undergoing emergency PCI, the formation of collateral circulation can significantly improve the coronary blood supply and reduce the infarct size. The history of angina pectoris was longer and the coronary artery lesion was more serious in the collateral circulation group, but because of the existence of collateral circulation, the LVEFN NT-proBNP was better than the non-collateral circulation group. These results suggest that collateral circulation plays a protective role in patients with myocardial ischemia, but there is no difference in the incidence of MACE between the patients without collateral circulation and the patients with mild coronary artery lesion.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R542.22

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

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2 葛均波;葛雷;黃榕

本文編號(hào)：1429806