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目的 比较早期冠脉介入治疗和行药物治疗稳定后的延迟冠脉介入治疗对非ST段抬高性急性冠脉综合征的疗效。方法 对 14 2例经危险分层为高危的非ST段抬高急性冠脉综合征患者行入院后早期 ( 72h)和药物治疗稳定后的延迟介入 ( 5～ 7d)治疗 ,并进行 6个月的随访 ,比较两组患者的围术期并发症的发生率、死亡、再次心肌梗死的发生率以及再入院率和再次血运重建术率。结果 早期介入组有 3例患者发生围手术期冠脉血栓事件 ,延迟介入治疗组有 4例患者于术前发生心肌梗死 ,随访 6个月两组患者死亡、心肌梗死和心绞痛的发生率差异无显著意义 (P >0 0 5 ) ,但在早期介入治疗组再次住院率 ( 17%∶2 2 % ,P <0 0 5 )和再次血管重建术率 ( 12 %∶17% ,P <0 0 5 )明显低于延迟介入治疗组。结论 对经危险分层为高危的非ST段抬高急性冠脉综合征患者入院后行在阿司匹林、利吡格雷和低分子肝素保护下早期冠脉介入治疗是安全的 ,可改善患者的预后
Objective To compare the effects of early coronary intervention (PCI) and delayed coronary intervention (PCI) on non-ST-segment elevation acute coronary syndrome after stable drug treatment. Methods A total of 142 patients with non-ST-segment elevation acute coronary syndrome who were at risk of stratification were treated with delayed intervention (5-7 days) after the first hospitalization (72 hours) and after stabilization of drug treatment for 6 months The incidence of perioperative complications, the incidence of death, reinfarction, and rates of readmission and revascularization were compared between the two groups. Results Perioperative coronary thrombosis occurred in 3 patients in the early intervention group. Four patients in the delayed intervention group had myocardial infarction before surgery. The death rate, myocardial infarction and angina pectoris in the two groups were followed up for 6 months (17%: 22%, P <0 05) and the rate of revascularization (12%: 17%, P <0 0) in the intervention group 5) was significantly lower than delayed intervention group. Conclusions Early percutaneous coronary intervention under the protection of aspirin, clopidogrel and low molecular weight heparin in patients with non-ST-segment elevation acute coronary syndrome who are at high risk for risk stratification is safe and may improve their prognosis