急诊直接冠脉介入治疗对急性心肌梗死预后的影响

Effect of clinical prognosis of emergent immediate percutaneous coronary intervention therapy in patients with acute myocardial infarction

目的探讨急诊直接经皮冠状动脉介入治疗(PC I)对急性心肌梗死(AM I)患者近期及远期预后的影响。方法将65例初次AM I分为2组,直接PC I组(A组)35例及静脉溶栓成功组(B组)30例。比较分析住院及随访期间上述两种方法主要临床事件发生率。结果①住院期间A组和B组平均住院天数(d)、出血(%)、再发不稳定心绞痛(%)、非致死心肌梗死(%)、心源性死亡(%)、住院期死亡及复合终点事件(不稳定型心绞痛、心肌梗死和死亡的总和)(%)等指标之间比较有明显差异(P<0.05);②随访期间A组左室扩大(%)、室壁瘤形成(%)、死亡及复合终点事件(%)、再狭窄(%)等发生率低于B组(P<0.05)、存活率(%)及射血分数(%)显著高于B组(P<0.05)。结论急诊直接PC I治疗是AM I早期再灌注安全有效的方法,对提高再通率、减少并发症及改善心功能是非常有益的。

Objective To compare the short and long term prognosis of immediate percutaneous coronary intervention （PCI） with intravenous thrombolytic（IT） therapy in patients with acute myocardial infarction（AMI）, and to evaluate the better outcomes of short and long term prognosis of emergent immediate PCI for patients with AMI. Methods 65 patients with AMI were divided into emergent immediate PCI group（group A ,35 cases）,IT therapy group （group B, 30 cases）, compared the inhospital and followup period cardiac events of emergent immediate PCI with IT therapy. Results ① The significant difference was observed in the eontex inhospital cardiac events between group A and group B（P〈0. 05）. ② During follow-up period ,the occurrence rates of cardiac events and cardiac death were lower in group A than in group B. The restenosis rate of infarct related artery were lower in group A than in group B. The survival rate and I.VEF were higher in group A than in group B （P〈0. 05）. Conclusion Immediate PCI for patients with AMI is a good choice of revascularization and a better outcomes of improving short and long term prognosis.