摘要
目的 探讨直接经皮冠状动脉介入 (PCI)和静脉溶栓治疗急性心肌梗死 (AMI)的临床疗效。方法 不同时期连续 13个月收治的AMI患者 ,分为溶栓组 ( 5 7例 )和PCI组 ( 75例 )。比较两组的再灌注率及住院和随诊期间心脏事件发生的情况。结果 溶栓组再灌注率为 5 7.9% ,PCI组为 96.0 %。超声心动图示溶栓组左心室射血分数 (LVEF)值为 0 .5 9± 0 .12 ,PCI组为 0 .63± 0 .10。两组在住院期间心脏事件发生率的差异无显著性 ;而随访期间心脏事件发生率 :PCI组和溶栓组的不稳定心绞痛发生率分别为 9.3 %和 3 8.6% ,非致死性心力衰竭为 4.0 %和 14 .0 % ,死亡 0 %和 7.0 % ,复合终点事件 9.3 %和 5 0 .9% ,差异均有显著性。结论 与静脉溶栓相比 ,直接PCI能更快、更满意地开通梗死相关血管 ,抢救濒临死亡的心肌 ,改善心功能 ,降低病死率。
Objective To compare the efficacy of primary PCI and venous thrombolysis in patients with AMI. Methods One hundred and thirty two consecutive patients with acute myocardial infarction within thirteen months were divided into primary PCI group( n =75) and venous thrombolysis group( n =57).The reperfusion rate and cardiac events during in hospital and follow up were recorded in both groups. Results The reperfusion rates of venous thrombolysis were 57.9% and 96% in primary PCI group( P < 0.01 ). Values of LVEF were 0.59±0.12 and 0.63+0.10 ( P < 0.05 ) respectively in the two groups. There was no significant difference in cardiac events of in hospital patients of the two groups, but during the follow up period, the unstable angina (9.3% vs 38.6%, P < 0.01 ), non fatal heart failure (4.0% vs 14.0%, P < 0.05 ), mortality rate (0% vs 7.0%, P < 0.05 ) and composite events (9.3% vs 50.9%, P < 0.01 ) were significantly lower in primary PCI group than those in venous thrombolysis group. Conclusions Primary PCI can improve the patency of the infarct related vessel faster and more satisfactorily, and is better than venous thrombolysis in improving myocardial function and reducing the mortality rate.
出处
《上海医学》
CAS
CSCD
北大核心
2003年第5期338-340,共3页
Shanghai Medical Journal
