急诊PTCA与溶栓治疗急性心肌梗死近期疗效对比研究

Short term efficiency of emergency percutaneous transluminal coronary angioplasty compared with thrombolysis in acute myocardial infarction

目的:对急诊PTCA和溶栓在急性心肌梗死(AMI)治疗中的近期疗效作一对比研究。方法:回顾性分析中山医院自2001年1月至2001年11月收治的行急诊PTCA和溶栓治疗的85例AMI患者的资料.并分析其临床不良事件的发生率、超声心动图检查结果。结果:急诊PTCA患者49名,溶栓患者36名。溶栓组的室性心律失常发生率(25%)、梗死后心绞痛(22.22%)、心源性休克(25%)、左室室壁运动积分指数(1.82±0.32)、行冠状动脉旁路手术(CABG)者(13.89%).死亡率(27.78%).平均住院天数(25.06±16.37)d.分别高于PTCA组的2.04% (P<0.01)、6.12%(P<0.05)、6.12%(P<0.05)、1.47±0.34(P<0.01)、0(P<O.05)、10.2%(P<0.05)、(16.90±10.05)d(P<0.01)。溶栓组的左室射血分数为0.39±0.16.显著低于PTCA组的0.56±0.13(P< 0.01)。结论:急诊PTCA可以减少梗死后心绞痛、室性心律失常等并发症的发生,并且可以显著改善左室心功能, 降低死亡率.缩短住院天数。

Objective:To compare the short-terra efficiency of emergency percutaneous transluminal coronary angioplas-ty (PTCA) and thrombolysis in acute myocardial infarction (AMI). Methods:A total of 85 AMI patients were randomly divided into PTCA group (49 cases) .thrombolysis group (36 cases). The clinical data of adverse events and echocar-diography examined of two groups were recorded. Results: For the thrombolysis group the incidents of ventricular arrhythmia (25%), angina after AMI (22. 22%), cardiac shock (25%), performed CABG (13. 89%), left ventricular wall motion score index (WMSI,1.82±0.32). mortality (27. 78%), average hospital days (25. 06±16. 37) d were respectively higher than homologous those [2.04% (P<0. 01), 6. 12% (P<0. 05), 6. 12% (P<0. 05), 1. 47±0. 34 (P<0. 01), 0 (P<0. 05), 10. 2% (P<0. 05), (16.90±10.05) d (P<0.01)] of PTCA group, but left ventricular ejection fraction (LVEF) of thrombolysis group was less than PTCA group (0. 39±0. 16 vs 0. 56±0. 13) (P< 0. 01). Conclusion: The PTCA may decrease incidents of complication such as ventricular arrhythmia, angina etc.,improve heart function, decrease mortality and average hospital days.