邵海峰 王丽

[摘要] 目的 探究急性ST段抬高型心肌梗死患者直接經皮冠状动脉介入治疗后非梗死相关动脉病变进展的临床情况。方法 方便选择2016年5月—2018年1月期间在该院接受治疗的急性ST段抬高型心肌梗死患者，共抽选280例，根据急诊PCI是否对非梗死相关血管进行处理将患者分为两组，其中参照组患者仅对罪犯血管进行处理，研究组患者在对罪犯血管进行处理的同时，对非梗死相关血管予以处理，比较两组患者的手术临床指标、心绞痛发生率、再次住院率、再次手术率以及心血管不良事件发生率。结果 研究组患者术后24 h左室射血分数为（48.76±5.11）分，NYHY心功能分级为（1.18±0.52）级，其数据明显优于参照组（t=6.512，P=0.000;t=2.845，P=0.005）;同时，研究组患者心绞痛发生率、再次住院率、再次手术率分别为36.4%、10.0%、9.1%，其数据与参照组相比较差异有统计学意义（χ2=8.148，P=0.004;χ2=6.952，P=0.008;χ2=40.491，P=0.000）。结论 急性ST段抬高型心肌梗死患者直接接受经皮冠状动脉介入治疗时，对严重狭窄的非梗死相关血管进行处理可以有效控制患者心绞痛发作，对于改善患者临床指标，提高预后效果具有显著临床效果。

[关键词] 急性ST段抬高型心肌梗死;直接经皮冠状动脉介入治疗;非梗死相关血管;病变;心功能;心血管不良事件

[中图分类号] R5          [文献标识码] A          [文章编号] 1674-0742（2020）06（a）-0089-03

Clinical Study on the Progression of Non-infarction-related Arterial Disease in Patients with Acute ST-segment Elevation Myocardial Infarction after Direct Percutaneous Coronary Intervention

SHAO Hai-feng， WANG Li

Department of Cardiology， the Third Affiliated Hospital of Qiqihar Medical College， Qiqihar， Heilongjiang Province， 161000 China

[Abstract] Objective To investigate the clinical status of non-infarction-related arterial disease progression in patients with acute ST-segment elevation myocardial infarction after direct percutaneous coronary intervention. Methods A total of 280 patients with acute ST-elevation myocardial infarction who were treated in the hospital from May 2016 to January 2018 were convenient selected， and the patients were divided into two groups according to whether the emergency PCI treated non-infarct-related blood vessels. The patients were divided into two groups， of which the reference group treated only the criminal's blood vessels， while the study group treated the non-infarct-related blood vessels while treating the criminal's blood vessels， and compared the clinical indicators of surgery， the incidence of angina pectoris， and the rate of rehospitalization， the rate of reoperations and the incidence of cardiovascular adverse events. Results The left ventricular ejection fraction of patients in the study group was （48.76±5.11） points and the NYHY cardiac function classification was（1.18±0.52）. The data was significantly better than the reference group（t=6.512，P=0.000;t=2.845，P=0.005）; At the same time， the incidence of angina pectoris， rehospitalization rate， and reoperation rate in the study group were 36.4%， 10.0%， and 9.1%， respectively. Compared with the reference group， the difference was statistically significant（χ2=8.148，P=0.004;χ2=6.952，P=0.008;χ2=40.491，P=0.000）. Conclusion When patients with acute ST-segment elevation myocardial infarction directly receive percutaneous coronary intervention， the treatment of severely narrowed non-infarction-related blood vessels can effectively control the onset of angina pectoris in patients， which has significant clinical effects on improving clinical indicators and prognosis of patients.

[Key words] Acute ST-segment elevation myocardial infarction; Direct percutaneous coronary intervention; Non-infarct-related blood vessels; Lesions; Cardiac function; Cardiovascular adverse events

经皮冠状动脉介入治疗能够及时疏通严重狭窄的梗死动脉，进而最大程度地减少ST段抬高型心肌梗死的病死率，有利于改善患者的预后，是临床治疗ST段抬高型心肌梗死再灌注的重要手段[1];但是，近……