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目的:总结非ST段抬高性心肌梗死(NSTEMI)患者行急诊介入治疗(PCI)的临床疗效及随访结果。方法:2000年2月￣2005年2月间,共收治142例NSTEMI患者,年龄36～82岁;其中6例行外科搭桥(CABG)治疗,136例行急诊PCI;发病到急诊PCI时间为1.5～11h。结果:136例行PCI者,131例成功,成功率96.3%。共治疗133处病变,置入支架177枚,4例患者仅行球囊扩张术。2例死亡,1例死于心源性休克,1例死于颅内出血。2例术后1周内支架内亚急性血栓形成。住院期间无其他严重心血管事件发生。129例患者门诊随访12个月,无不良心血管事件发生,86例PCI患者术后6～12个月行冠脉造影检查,再狭窄10例,8例金属裸支架者(16%)、2例药物洗脱支架者(5.6%)。结论:非ST段抬高型心肌梗死急诊介入治疗安全有效,能明显改善临床症状。药物洗脱支架可降低再狭窄发生率。
Objective: To summarize the clinical effects and follow-up results of emergency PCI in patients with non-ST-segment elevation myocardial infarction (NSTEMI). METHODS: Between February 2000 and February 2005, 142 patients with NSTEMI were enrolled, aged 36-82 years. Six of them received CABG and 136 had emergency PCI. The time from onset to emergency PCI was 1.5 ~ 11h. Results: 136 cases of PCI, 131 cases were successful, the success rate of 96.3%. A total of 133 lesions were treated, and 177 stents were placed. Only 4 patients underwent balloon dilatation. Two died, one died of cardiogenic shock and one died of intracranial hemorrhage. 2 cases of intracranial subacute thrombosis within 1 week after operation. No other serious cardiovascular events occurred during hospitalization. 129 outpatients were followed up for 12 months with no adverse cardiovascular events. Coronary angiography was performed in 86 PCI patients 6 to 12 months after surgery. Restenosis was performed in 10 patients, 8 patients with bare metal stent (16%) and 2 patients Drug-eluting stents (5.6%). Conclusion: The interventional treatment of non-ST elevation myocardial infarction in emergency is safe and effective, and can significantly improve the clinical symptoms. Drug-eluting stents reduce the incidence of restenosis.