直接经皮冠状动脉成形术联合脂微球载体前列腺素E1治疗老年急性心肌梗死

The clinical study on direct percutaneous transcoronary angioplasty combined with Lipo-PGE1 in treating senile acute myocardial infarction

目的探讨直接经皮冠状动脉成形术(PTCA)联合脂微球载体前列腺素E1(Lipo-PGE1)治疗老年(≥70岁)急性心肌梗死的有效性和安全性。方法采用前瞻性研究方法,对147例发病时间12h内、70岁及以上的急性心肌梗死患者分为2组,联合组73例行直接PTCA联合脂微球载体前列腺素E1治疗;单纯治疗组74例,仅单纯行直接PTCA,分别对其临床资料进行分析,并随访1月。结果联合治疗组中术后半小时心电图ST段下降较未联合应用组明显,24h和术后4周心功能改善较著,未出现血压、心率等的不良改变。结论直接PTCA联合脂微球载体前列腺素E1治疗老年(≥70岁)急性心肌梗死可明显保护患者心功能,近期疗效较单纯直接PTCA者佳,无不良反应,值得临床推广应用。

Objective The aim of the study is to discuss the validity and security of direct percutaneous transcoronary angioplasty combined with liposomal prostaglandin E1 （ Lipo-PGE1） for treating elderly （≥70 岁） acute myocardial infarction （AMI） . Methods 143 elderly patients （≥70 years old） with AMI within 12 hours from symptom onset are divided into two groups randomly. The one just underwent direct PTCA combined with Lipo-PGE1, （ as PTCA combined with Lipo-PGE1 group,73 elderly patients）, The other one underwent PTCA （as PTCA group, 74 elderly patients）. Their clinical information were analyzed respectively by prospective. The period＇of follow up was a month. Result The PCTA combined with Lipo-PGE1 group, their ST segments on EKG 30 minutes after operations reduced significantly than that of patients who did not use Lipo-PGE1, their cardial functions were also improved significantly 24 hours and 1 month after operations and no side effects on blood pressure and heart rate. Conclusion The emergent PTCA combined with Lipo-PGE1 for acute myocardial infarction can protects patient＇s cardial function and shows a better early therapy effect. We could find no side effect. It is worth applying spreadly.