摘要
目的 比较急诊冠状动脉介入治疗 (PCI)与静脉溶栓治疗对急性心肌梗死 (AMI)患者近期的临床效果。方法 2 18例ST段抬高的急性心肌梗死患者 ,10 1例患者接受静脉溶栓治疗 (溶栓组 ) ,117例接受急诊PCI治疗 (PCI)组 ,比较接受两种治疗方法患者住院期间的临床结果。结果 溶栓组梗死相关血管 (IRA)再通率为 70 4 % ;急诊PCI组IRA再通率为 98 8% ;30d时左室射血分数 (EF)溶栓组为5 6 1± 11 2 ,急诊PCI组为 6 0 2± 9 1,差异有显著性 (P <0 0 5 ) ;病死率分别为 8 9%和 3 4 % ,两组间差异有显著性(P <0 0 5 )。分析溶栓再通组与急诊PCI组的临床疗效 ,前者再发梗死、发生心肌缺血事件和心力衰竭 ,比率明显高于急诊PCI组 (30 7%vs 15 3% ,P <0 0 5 )。溶栓组平均住院天数为 15 8d[(12 3± 6 8)d],PCI组平均住院天数为 10 2d[(7 2± 3 1)d],两组间差异有显著性 (P <0 0 5 )。结论 急诊冠状动脉介入治疗与静脉溶栓治疗急性心肌梗死患者对比 ,前者可充分有效地开通IRA ,降低死亡率 ,能更好地改善患者心功能 ,缩短住院时间。
Objectives To compare the efficacy of emergent percutaneous coronary intervention (PCI) and thrombolytic therapy in acute myocardial infarction. Methods In a total of 218 cases of acute myocardial infarction (AMI), 101 cases were treated with intravenous thrombolytic therapy, 117 cases were treated with emergent PCI. The clinical outcomes between these two groups were compared. Results In patients treated with intravenous thrombolysis, the infarct-related artery (IRA) reperfusion rate was 70.1%. While in the PCI group, the IRA reperfusion rate was 98.2% and 95.4% gained TIMI 3 blood flow. There was significant differences in left ventricular ejection fraction (LVEF) in 30 days after AMI between thrombolytic group and the PCI group ( 51.6%±12.3% vs 62.7%±10.1%, P<0.05). Mortality was higher in thrombolytic therapy group than in the PCI group (8.9% vs 3.4%, P<0.05). The average days staying in-hospital was less in the PCI group than in the thrombolytic group. Conclusions Emergent PCI is more effective than thrombolytic therapy in reperfusion of IRA and in improving the cardiac function after AMI. The treatment of PCI can reduce the mortality of AMI and the days staying in-hospital.
出处
《岭南心血管病杂志》
2004年第1期43-45,共3页
South China Journal of Cardiovascular Diseases
