早期不同治疗方法对急性ST段抬高心肌梗死的疗效分析

Early different therapeutic methods for acute ST segment elevation myocardial infarction analysis

目的探讨早期不同的治疗方法对急性ST段抬高性心肌梗死的疗效和安全性。方法将69例急性ST段抬高心肌梗死(STEMl)按治疗方法的不同分为急诊经皮冠状动脉介入治疗组(PCI组)22例,早期药物溶栓治疗组14例,普通药物治疗组33例,分析不同治疗的急性心肌梗死患者的血管再通率、住院时间和并发症的发生率。结果平均住院时间急诊PCI组和溶栓治疗组明显短于常规治疗组;急诊PCI组血管再通率显著高于溶栓治疗组;急诊PCI组手术后获得前向血流TIMI3级100%,急诊PCI组住院死亡率显著低于其他两组,分别为0.0%,7.1%,12.1%。急诊PCI组治疗后ST段回落50%时间、胸痛缓解时间、CKMB达峰时间与溶栓治疗组比较有显著性差异。结论 STEMI行急诊PCI治疗优于溶栓和常规治疗。急诊PCI可以显著降低急性心肌梗死患者的住院病死率。

Objective To investigate the efficacy and safety of the early different therapeutic methods for acute ST segment elevation myocardial infarction （STEMI）. Methods 69 cases of acute STEMI patients were divided into emergency revascularization group（ n =22 cases） ,selective revascularization group combined with Intravenous throm- bolysis（ n = 14 cases） ,Common drug treatment group（ n = 33cases） ,The clinical data of the patients with the ST--El- evation acute myocardial infarction （STEAMI） treated routine （ 33 cases）, thrombolytic （ 14 cases） and emergency percutaneous coronary intervention（PCI） （22 cases）were analyzed. The days in-hospital, rate of repufusion and major events among patients with STEM1 were studied, studied. Results The daysin--hospital of emergency PCI and thrombolytic was shorter than that of routine. The reperfusion rate of thrombolytic was lower than that of emergency PCI. After operations,22 patients（ 100% ） of emergency PCI gained TIMI 3 gradeof perfusion flow ,In--hospital morality of STEMI in PCI group Was significantly lower than other groups. They were 0. 0% ,7.1%, 12.1% respectively, Emergency PCI group after treatment ST down 50% time, chest pain relief time, CKMB peak time and thrombolytic therapy group with significant difference. Conclusion The emergency PCI in patients with STEMI was effective and safe. PCI decreased in-hospital morality of AMI patients, meanwhile thrombolytic therapy were very important.