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目的 :探讨心肌梗死 (MI)后再发心肌缺血且闭塞远端已有侧支循环建立病例 ,闭塞冠状动脉 (OCA)内支架植入疗效。方法 :MI后再发心肌缺血行冠脉内支架植入治疗 1 32例 ,冠状动脉造影均见闭塞远端侧支循环建立 ,分为OCA再通组 (A组 )及未通组 (B组 ) ,随访 6～ 1 8个月并进行心绞痛分级 ,测定左室射血分数 (LVEF) ,统计心脏事件。结果 :总手术成功率 95 .4 % ,OCA再通植入支架成功率为 80 .3% ,A组与B组比较 ,平均植入支架数量多 (P <0 .0 1 ) ;心脏事件发生率少 (P <0 .0 1 ) ,心绞痛发作程度减轻 (P <0 .0 1 ) ,LVEF改善 (P <0 .0 1 )。结论 :MI后冠状动脉闭塞 ,远端已有侧支循环建立的病例 ,植入支架可有效缓解心绞痛发作 ,改善左室功能 ,减少心脏事件的发生。
Objective: To investigate the effect of stent implantation after occlusion of coronary artery (OCA) in patients with myocardial ischemia after myocardial infarction (MI) and occlusion of distal collateral circulation. Methods: One hundred and thirty-two patients undergoing coronary stent implantation after myocardial infarction were treated with coronary angiography. The distal collateral circulation was established. The patients were divided into OCA recanalization group (A group) and non-recanalization group Group). The patients were followed up for 6 ~ 18 months and angina pectoris was graded. Left ventricular ejection fraction (LVEF) was measured and cardiac events were recorded. Results: The total success rate of operation was 95.4% and the success rate of OCA replantation was 80.3%. The average number of stents implanted in group A was significantly higher than that in group B (P <0.01) The rate of angina pectoris was reduced (P <0.01) and LVEF was improved (P <0.01). Conclusion: After coronary artery occlusion in MI, there are cases of distal collateral circulation. The implantation of stent can effectively relieve angina pectoris, improve left ventricular function and reduce the incidence of cardiac events.