摘要
目的:研究急性心肌梗死后直接经皮冠脉介入治疗(PCI)和溶栓后补救性PCI的临床造影结果和短期预后,观察终点为30天的死亡率。 方法:连续入选150例ST段抬高的急性心肌梗死患者。按溶栓与否分为直接PCI组110例(73.3％)和溶栓后补救性PCI组40例(26.7％),溶栓药物包括重组葡激酶、重组组织型纤溶酶原激活剂、重组纤溶酶原激活剂和尿激酶。分析其临床、造影和预后特点。 结果:与溶栓后补救性PCI组比较,直接PCI组CK和CK-MB峰值低(P<0.05),校正的心肌梗死溶栓临床试验的帧数(corrected TIMI framecounts,CTFC)低(P<0.05),心肌梗死溶栓临床试验心肌灌注分级(TIMI myocardial perfu-sion grades,TMPG)高(P<0.05),死亡率显著降低(P<0.01)。 结论:溶栓后补救性PCI可能使心肌酶增高,死亡率增加。
Objective:To study the clinical and angiographic characteristics and the short-term outcome of primary-PCI and rescue-PCI after thrombolysis in acute myocardial infarction. Methods: A total of 150 consecutive acute myocardial infarction patients with ST segment elevation were divided into two groups : primary-PCI group(n= 110) or rescue-PCI group(n = 40). The drugs for thrombolysis included r-SAK,rt-PA,r-PA and UK. The clinical, angiographic and prognostic features were analyzed. Results: Compared to rescue-PCI group,the peak values of CK, CK-MB were low(P<0. 05) ,CTFC(corrected TIMI frame counts)was low(P< 0. 05) ,TMPG(TIMI myocardial perfusion grades)was high(P<0. 05) and mortality rate was significantly de-creased(P<0. 01) in primary-PCI group. Conclusions: Rescue-PCI could increase mortality rate and the value of cardiac enzymes.
关键词
溶栓
直接PCI
急性心肌梗死
补救性
死亡率
临床试验
对比研究
峰值
校正
增加
Acute myocardial infarction Primary percutaneous coronary intervention Thrombolysis Rescue percutaneous coronary intervention
