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目的:探讨急性心肌梗死(AMI)患者梗死相关冠状动脉病变形态特点和发生无复流现象(noreflow)的关系。方法:43例行急诊介入治疗的AMI患者,男35例,女8例,平均年龄(65±9)岁,观察其梗死相关冠状动脉病变形态特点与发生“无复流现象”的关系。结果:有5例患者在急诊介入治疗后发生了“无复流现象”。这些患者梗死相关冠状动脉病变特点:血管闭塞处近端呈蟹钳样改变,造影后闭塞局部造影剂滞留时间明显延长。急诊介入治疗前TIMI血流分级为0～1级。结论:AMI患者梗死相关冠状动脉闭塞近端呈蟹钳样改变伴造影剂长时间滞留者和介入治疗术后“无复流现象”发生有一定的关系。
Objective: To investigate the relationship between morphological characteristics of infarction-related coronary lesions and noreflow in patients with acute myocardial infarction (AMI). Methods: A total of 43 AMI patients undergoing emergency interventional therapy were enrolled in this study. There were 35 males and 8 females with an average age of (65 ± 9) years old. The relationship between infarction-related coronary lesions and occurrence of “no-reflow phenomenon” was observed. Results: Five patients developed “no-reflow phenomenon” after emergency intervention. The characteristics of infarction-related coronary artery lesions in these patients were: crab clamp-like changes in the proximal end of the vessel occlusion, and prolonged residence time of local contrast agent in the occlusion after angiography was significantly prolonged. TIMI blood flow grading was 0 to 1 prior to emergency intervention. CONCLUSIONS: There is a certain relationship between AMI patients with crab clamp-like changes in the proximal end of infarction-associated coronary artery occlusion and those with long-term contrast agent retention and “no-reflow phenomenon” after interventional therapy.