【摘要】 目的　比较单支与多支血管病变急性心肌梗死 (AMI)患者直接经皮冠状动脉介入 (PCI)后住院期间心功能和心脏事件的发生率。方法　 115例AMI患者 ,均于发病后 12h内直接PCI和支架术。根据急诊冠状动脉造影结果将患者分为单支血管病变组 (甲组 ) 6 6例和多支血管病变组 (乙组 ) 4 9例。询问有无梗死前心绞痛史 ,发病后 10d作二维心动超声检查 ,出院前记录心脏事件。结果　甲组 12例出现梗死前心绞痛 (12 / 6 6 ) ,乙组 18例 (18/ 4 9) ,P <0 .0 1;甲组PCI后平均左心射血分数为 (6 3.0 0±6 .76 ) % ,乙组为 (6 2 .18± 8.5 2 ) % ,P >0 .0 5 ;术后甲组心功能衰竭发生 6 / 6 6 ,乙组为 4 / 4 9,P >0 .0 5 ;甲组心绞痛发生 3/ 6 6 ,乙组为 2 / 4 9,P >0 .0 5 ;甲组恶性心律失常发生 2 / 6 6 ,乙组为 3/ 4 9,P >0 .0 5 ;甲组心源性死亡发生 2 / 6 6 ,乙组为 0 ,P >0 .0 5 ;甲组复合终点事件为 13/ 6 6 ,乙组为 9/ 4 9,P >0 .0 5 ,均无显著统计学差异。结论　无论单支或多支血管病变AMI后对梗死相关动脉行直接PCI均同样有效更多还原

【Abstract】 Objective To compare the effect of primary percutanuous coronary intervention (PCI) in multivessel and one vessel involvement in AMI patient during hospital stay, using LVEF and cardiac events as end point. Methods : One hundred and fifteen cases of AMI were dichotomized into one vessel group (66 group A) and multivessel group (49 group B). Preinfarction angina was noted. Two-dimensional echocardiograms were carried out 10 days after onset of symptoms. Adverse cardiac events were recorded before discharge. Results: Twelve patients in group A exhibited preinfarction angina (12/66); in group B 18 cases displayed the same(18/49), P< 0.01. In group A ,mean LVEF was 63.00+6.76%,which in group B, it was 62.18+8.52%, P >0.05;Heart failure occurred in 6 cases in group A (6/66), and 4 in group B (4/49); P >0.05;Three cases had angina in group A (3/66); in group B, only 2 cases (2/49), P >0.05. Two patients developed malignant ventricular arrhythmias in group A (2/66) ; in group B , 3 cases (3/49), P > 0.05 . As far as cardiogenic shock was concerned it was 2 in group A , none in group B, P >0.025. The compound end points was 13/66 in group A and 9/49 in group B , P >0.05, all statistically insignificant. Conclusions: Primary PCI was equally effective for the treatment of one vessel and multivessel AMI patients.更多还原