超声血管成形术治疗急性心肌梗死的安全性及近期疗效.doc

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1、超声血管成形术治疗急性心肌梗死的安全性及近期疗效作者：宋耀明，何作云，黄岚，李爱民【关键词】急性心肌桢死【Abstract]AIM:Toevaluatethesafetyandshorttermoutcomeofultrasoundangioplastyintreatmentofacutemyocardialinfarction(AMI).METHODS:Atotalof28patientswithAMIweretreatedbycoronaryultrasoundthrombolysis.Thedegreeofs

2、tenosiswasmeasuredandanalyzedwithINNOVA2000computerizedanalyzingsystemandthechangesinimagingandbloodf1owinIRA,CKMBvalue,STsegmentinECGandclinicalmanifestationsbeforeandafterthetreatmentwereobservedtoevaluatethefeasibilityofangioplastywithultrasoundintreatingAM

3、T.CTFCwasmeasuredimmediatelyaftersuccessfulultrasoundthrombolysis(TIMI3).RESULTS:AtleastoneIRAwithmassivethrombosiswasfoundinallthe28patients.TherepeatedangiographyattheendofultrasoundthroinbolysisshowednoimageofthrombiagainandIRAachievedgradeIIIofTIMIbloodflo

4、win27outofthe28patientswithAMT(potencyrecoveringrate=96.4%).Thestenosisdecreasedsignifiedntlyaftertheoperation(0.48±0.12vs0.88±0.09,P<0.05)andCTFCwaslessthan23count/second(mean15>4±3>7count/second)in26patients.Disappearanceofchestpain,remarkabledecreaseinST

5、segment(0.064±0.013mVvs0.231±0.058mV,P<0.01)andobviousmigratingforwardofCKMBpeakvaluewerefoundin27patients.Therewerenoadverseclinicaleventsduringtheprocedureandhospitalization.CONCLUSION:Percutaneoustransluminalcoronaryultrasoundthrombolysiscanbeusedasanewa

6、pproachtotreatacutemyocardialinfarction,foritcanopenIRAasearlyaspossible,restoregradelllTIMIbloodflowandimprovedistalcoronaryreperfusion.[Keywords]arteryangioplasty;acutemyocardialinfarction;infarctionrelatedartery【摘要】冃的:评价经皮冠状动脉内超声血管成形术治疗急性心肌樓死(AMI)的近期疗效及安全性.

7、方法:通过导管技术对28例急性心肌梗死患者的梗死相关血管血栓行血管内超声消融，比较超声消融前后梗死相关血管的狭窄程度、TIMI血流、静脉血中CKMB浓度、心电图ST段及临床症状的改变，计算消融后的校止TIMI帧数.结果：28例患者均有一支有大量血栓的IRA,消融(102.26±11.24)s后IRA达TIMI3级27例，开通率为96.4%(27/28),消融后IRA狭窄明显减轻(0・48±0・12vs0.88±0.09,P<0.05),CTFC<23(15.4±3.7c/s)26例.消融成功后10min

8、内患者胸痛消失，术后(3.67±0.48)h血中CKMB浓度达到高峰,术后6h抬高的ST段明显回落(0.064±0.013mVvs0.231±0.058mV,P<；0.01)・28例患者消融术中及住院期间无死亡，无心源性休克、复发严重心肌缺血、再梗死等严重并发症.结论:低频高能超声血管成形术治疗AMI,可使IRA早期再通，恢复TIMI3级血流和较好的远端