心肌梗死介入与保守治疗长期疗效观察

Long-term effects of percutaneous coronary interention and conservative treatment for myocardial infarction

目的:比较心肌梗塞介入治疗与保守治疗长期疗效的差异。方法:对上述两种方法治愈出院的病人182例进行随访研究,其中介入治疗组89例,药物治疗组93例,随访两组患者心脏事件发生率、再住院率、生存率及心功能情况。结果:1年时介入组和药物组心脏事件发生率分别为19.1%和34.4%,再住院患者分别为24.7%和39.8%;3年随访时介入组和药物组心脏事件发生率分别为22.9%和37.6%,需再住院患者分别为25.8%和43.0%,3年时介入组和药物组生存率分别是96.6%和91.4%;介入组心功能优于药物组(P<0.05)。其中前壁心肌梗死1年、3年随访时介入与药物组的心脏事件发生率分别为27.5%和53.5%,30.0%和58.1%,再住院率分别是30.0%和58.1%,30.0%和65.1%。3年时生存率为92.5%和83.7%。治疗后介入组心功能明显优于药物组(P<0.05)。结论:介入治疗明显降低心脏事件发生率,减少再住院率,提高生存率,改善心功能。下壁心肌梗死病人介入组和药物组预后差别不大,对于前壁心肌梗死长期结果显示介入治疗明显优于药物治疗组,尤其在生存率上和心功能保护方面差别明显。

Objective： To study the difference of treat effective in patients with myocardial infarction （MI） with percutaneous coronary intervention （PCI） or drug treatment. Methods： 182 pa- tients with MI by treated were studied by dewelled on, 89 patients were treated by PCI,93 patients were treated by drug. Which were observed major adverse cardiac events （MACE） , Second in- hospital rate, survival rate and left ventricular ejection fraction（LVEF）. Results： MACE rate with PCI or drug in one year was 19. 1% and 34. 4% , Second in-hospital rate was 24. 7% and 39.8%. MACE rate with PCI or drug in three years was 22.9% and 37.6% , Second in-hospital rate was 25.8% and 43.0% , Survival rate with with PCI or drug in three years was 96.6% and 91.4% , LVEF was significantly higher in PCI than in drug （P 〈 0.05）. MACE rate with anterior all MIwith PCI or drug in one year and three years was 27.5% and 53.5%,30.0% and 58.1%, Second in-hospital rate was 30.0% and 58.1% , 30.0% and 65.1% , survival rate in three years was 92.5% and 83.7% , LVEF was significantly higher in PCI than in drug （P 〈 0.05 ）. Conclusion： MACE rate, Second in-hospital was lower in PCI than in drug, however surviva rate, LVEF was higher in PCI than in drug, Prognosis with inferior wall MI was no difference of. PCI or drug. The long-term treatment of efficacy with anterior all MI was significantly higher in PCI than in drug, especially survival rate and LVEt were significantly higher.