摘要
目的 比较急性ST段抬高心肌梗死（STEMI）重组人尿激酶原溶栓后早期经皮冠状动脉介入治疗（PCI）与直接PCI的疗效.方法 2014年1月至2015年6月就诊于我院STEMI患者69例,根据治疗方法将患者分为尿激酶原溶栓后早期PCI组和直接PCI组,分别对两组患者梗死相关动脉（IRA）的再通率、并发症发生率、支架植入术、住院期间死亡率及1个月后患者左室射血分数（LVEF）等指标进行比较分析.结果 溶栓后早期PCI组共纳入32例患者,直接PCI组共纳入37例患者.术前溶栓后早期介入组血管开通率为87.5％（18.7％为TIMIⅡ级血流,68.8％为TIMIⅢ级血流）,直接PCI组为18.9％（10.8％为TIMIⅡ级血流,8.1％为TIMIⅢ级血流）,两组比较差异有统计学意义（p＜0.01）.两组PCI术后血管再通率相似,分别为90.6％和89.8％（P=0.653）,但尿激酶原溶栓早期PCI组所用支架数更少.两组住院期间不良事件发生率（大出血、再闭塞、急性型左心衰和住院天数）无显著差异.1个月后随访LVEF、LVEDd、心源性死亡、再梗、脑卒中等未见统计学差异.结论 尿激酶原溶栓后早期PCI治疗是一种有效、安全的替代再灌注策略.
Objective Compare the efficacy early routine post-prourokinase thrombolysis percutaneous coronary intervention（early PCI） with primary percutaneous coronary intervention（PPCI） for acute ST-segment elevated myocardial infarction （STEMI）.Methods In January 2014 June 2015,69 patients were treated with STE-MI in our hospital.The patients were divided into early PCI group and primary PCI group.The incidence rate,complication rate,mortality rate,and left ventricular ejection fraction （LVEF） were compared between two groups.Results 32 patients in early PCI group and 37 in PPCI group were finally included.87.9% with early PCI group （18.7% Thrombolysis in myocardial infarction trial TIMI-2,68.8%TIMI-3）,and 18.9% with primary PCI group （10.8% TIMI-2,8.1%TIMI-3）（P〈0.01）.The blood flow rates were similar in the two groups after PCI operation,90.6%（early PCI group）,and 89.8%（primary PCI group）（P=0.653）,but the number of stents used in the early PCI group was less in primary PCI group.There was no significant difference in the incidence of adverse events in the two groups during hospitalization （major bleeding,acute left heart failure,and length of hospital stay）.After 1 months of follow-up,there were no significant differences in LVEF,LVEDd,cardiac death,myocardial infarction again,and stroke.Conclusion Early routine post-prourokinase thrombolysis PCI is an effective and safe reperfusion therapy strategy.
出处
《中国心血管病研究》
CAS
2017年第5期433-436,共4页
Chinese Journal of Cardiovascular Research
基金
山东省医药卫生科技发展计划项目（项目编号：2014ws0024）
关键词
急性ST段抬高型心肌梗死
溶栓
经皮冠状动脉介入治疗
尿激酶原
Acute ST-segment elevation myocardial infarction
Thrombolysis
Percutaneous coronary intervention
Prourokinase
