摘要
目的 :比较溶栓后经皮冠状动脉介入治疗(PCI)与直接PCI治疗急性ST段抬高型心肌梗死(STEMI)的效果。方法 :选取我院2016年1月-2017年5月收治的204例STEMI患者,将发病12 h内,且预估球囊扩张(D2B)时间<90 min者设为直接PCI组,急诊行PCI;预估D2B时间≥90 min,且接受溶栓后PCI者设为溶栓后早期PCI组,重组人尿激酶原溶栓后行早期PCI。结果 :溶栓后早期PCI组治疗前TIMI血流分级明显优于直接PCI组,差异有统计学意义(P<0.05);两组治疗后TIMI血流分级、住院期间出血、心脏不良事件发生率以及住院天数差异无统计学意义(P>0.05);溶栓后早期PCI组CK-MB峰值显著低于直接PCI组,差异有统计学意义(P<0.05);两组术后NT-pro BNP水平比较差异无统计学意义(P>0.05)。结论 :溶栓后早期PCI对于STEMI患者是一种安全有效的再灌注治疗方法,相比直接PCI,更适合在条件有限的基层医院推广。
objective:To compare the effect of percutaneous coronary intervention(PCI) after thrombolysis and primary PCI on acute st-segment elevation myocardial infarction(STEMI). Methods:204 patients with STEMI who were admitted to Second People's Hospital of Jiaozuo City from January 2016 to May 2017 were investigated. The patients suffering from STEMI within 12 hours with estimated ballon dilation(D2 B) time less than 90 minutes were enrolled to primary PCI group, and emergence treatment with PCI was applied. Patients with D2 B time equal to or greater than 90 minutes, and with treatement with PCI after the thrombolysis were enrolled to early stage PCI treatment after thrombolysis group, an early stage PCI was performed after the thrombolytsis with recombinant human prourokinase. Results:The TIMI blood flow grade before treatment of the early stage PCI treatment after thrombolysis group was superior than that of the primary PCI group, and the difference was statistically significant(P<0.05). There was no statisticall y significant difference in TIMI blood grade, hemorrhage d uring hospitalization, incidence of cardiac adverse events and hospital days between the two groups after treatment(P>0.05). The CK-MB peak value of early stage PCI tre atment after thrombolysis group is significantly lower than that of the direct PCI group(P<0.05). There was no sta tistically significant difference in NT-pro BNP level between the two groups after treatment(P>0.05). Conclusion:Early stage PCI after thrombolysis is a safe and effective reperfusion therapy for STEMI patients, and it is more suitable than primary PCI for the promotion of the basic hospital with limi ted conditions.
出处
《中国执业药师》
CAS
2018年第3期34-36,40,共4页
China Licensed Pharmacist