溶栓与直接PTCA对年轻人急性心肌梗塞患者疗效比较分析

An Evaluation of the Therapeutic Effects of Thrombolysis and Percutaneous Transluminal Coronary Angioplasty on Young Cases with Acute Myocardial Infarction

目的 :研究以溶栓或直接经皮冠状动脉腔内成形术 (PTCA)治疗年轻人急性心肌梗塞(AMT)的疗效。方法 :4 0岁以下AMT病人 50例分为溶栓治疗组 (30例 )和直接PTCA组 (2 0例 ) ,比较梗塞相关血管开通率和出院时左心室功能。结果 :尿激酶溶栓治疗组血流达TIMI 3级者 4 6 .2 % (14/ 30 ) ,且存在 80～ 95%的残余狭窄 ,出院时左心室射血分数 (LVEF)平均 4 5% ;直接PTCA治疗组术后血流全部达TIMI 3级 (10 0 % ) ,LVEF 6 0 % ,明显高于溶栓治疗组。结论 :年轻人AMI ,直接PTCA疗效明显高于溶栓治疗 ,值得推广。

To study the therapeutic effects of thrombolysis and percutaneous transluminal coronary angioplasty (PTCA) on young cases with acute myocardial infarction (AMI). Methods :50 cases with AMI and of ages younger than 40 years were divided into two groups,one group (30 cases) was subject to treatment with thrombolysis,the other group was treated by PTCA (20 cases). The rate of referfusion in infarction_involving blood vessels and the left ventricular function (LVEF) up to the patients′ discharge from hospital were compared between the two groups. Results: In thrombolysis (with urokinase)group,46.2% patients were with 3 grade flow of TIMI,the residual stenosis took 80～95%,and the average LVEF was 45%. In PTCA group,100% of the patients were with 3 grade flow of TIMI,the average LVEF was 60%,both of which were significantly greater than that in thrombolysis group (P<0.01). Conclusion:For young patients with AMI the therapeutic effect of PTCA is obviously better than that of thrombolysis treatment,so PTCA is worth recommending for the treatment of young patients with AMI.