PCI和静脉溶栓治疗急性心肌梗死的疗效比较

Comparison on the clinical efficacy of percutaneous coronary intervention and intravenous thrombolysis in the treatment of patients with acute myocardial infarction

目的探讨经皮冠状动脉介入(PCI)和静脉溶栓在急性心肌梗死患者中的应用价值。方法选择我院2013年1月至2014年9月收治的60例急性心肌梗死患者作为研究对象,随机分为实验组和对照组各30例。实验组患者采用PCI治疗,对照组患者采用静脉溶栓治疗,比较两组患者血管再通率、死亡发生率、ST段回落情况、住院时间、近远期不良事件发生率、左室舒张末径和左室射血分数变化情况。结果实验组血管再通率显著高于对照组,差异有统计学意义(P<0.05),而近期和远期不良事件发生率均低于对照组,近期不良事件发生率组间比较差异有统计学意义(P<0.05),而远期不良事件发生率比较差异无统计学意义(P>0.05)。实验组患者死亡发生率、ST段回落和住院时间均低于对照组,差异均有统计学意义(P<0.05)。实验组左室射血分数在术后1个月、3个月和6个月时均显著高于对照组,差异均有统计学意义(P<0.05)。结论急性心肌梗死患者应用PCI治疗可显著提高血管再通率、降低死亡和不良事件发生率,有效改善心功能。

Objective To evaluate the application value of percutaneous coronary intervention（PCI） and intravenous thrombolysis in patients with acute myocardial infarction. Methods Sixty patients from February 2013 to September 2014 in our hospital were chosen as the study objects, which were divided into experimental group and control group randomly. The control group was treated with intravenous thrombolysis, and the experimental group was treated with PCI. The recanalization rate, death rate, ST segment resolution, hospitalization time, short-term and long-term adverse event rates, left ventricular enddiastolic dimension and left ventricular ejection fraction change were compared. Results In experimental group, the recanalization rate was significantly higher than that in the control group, and the difference was statistically significant（P〈0.05）. The short-term and long-term adverse event rates were lower than those in the control group, with statistically significant difference between the two groups for short-term adverse event rates（P〈0.05） and no significant difference for long-term adverse event rates（P〈0.05）. The death rate,ST segment resolution, hospitalization time of experimental group was lower than those of the control group, and the difference was statistically significant（P〈0.05）. In experimental group, the left ventricular ejection fraction after January, March and June were higher than that in the control group（P〈0.05）. Conclusion Application of PCI in patients with acute myocardial infarction treatment can significantly improve the rate of recanalization, reduce the incidence of death and adverse events, and improve heart function.