在患有急性心肌梗塞的患者中,远距离保护改善了反射,并减少了左心室功能障碍,这些患者有血管学定义的破裂斑块
Isamu Mizote1, Yasunori Ueda, Tomohito Ohtani
1Cardiovascular Division, Osaka Police Hospital, Osaka, 543-0035, Japan.
Circulation
|August 17, 2005
概括
远距离保护有效地减少微循环损伤和左心室功能障碍急性心肌梗塞患者与破裂的斑块. 这种好处与防止斑块残留物栓塞,改善结果有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 血管生物学 血管生物学
背景情况:
- 远距离保护装置可以在穿皮冠状动脉干预 (PCI) 中防止远距离栓塞.
- 然而,它们在急性心肌梗塞 (AMI) 期间对本土冠状动脉的疗效仍在争论中.
- 损伤特征可能会影响远距离保护的有效性.
研究的目的:
- 调查病变特征,特别是破裂的斑块,对在AMI患者PCI期间远端保护的有效性的影响.
- 根据血管镜检查结果,比较用远端保护和不使用远端保护治疗的患者之间的结果.
主要方法:
- 一项队列研究比较了用 (n=81) 和没有 (n=110) 远端保护治疗的AMI患者.
- 用血管镜分类罪病变,以确定破裂的斑块.
- 评估的结果包括无反流现象,ST段分辨率,心肌红色度和6个月后左心室喷射率.
主要成果:
- 在没有远端保护的破裂斑块患者中,无反流最为频繁 (P<0.05).
- 在破裂斑块患者中,远距离保护显著改善了ST段分辨率,心肌红色度和左心室喷射率 (P<0.001).
- 从破裂的斑块吸取的样本经常含有大型斑块残留物 (>1毫米,97.3%) 和组织学上的斑块残留物 (95.3%).
结论:
- 远距离保护可以减少AMI患者的微循环损伤和左心室功能障碍,这些患者有血管学定义的破裂斑块.
- 斑块碎片的远端栓塞,而不是血栓,是这些患者微循环损伤和功能障碍的主要原因.
- 破裂斑块的血管镜鉴定对于确定AMI PCI中远距离保护的益处至关重要.
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