经皮冠状动脉介入术与尿激酶静脉溶栓治疗急性心肌梗死的疗效对比

Clinical effect of percutaneous coronary intervention versus urokinase intravenous thrombolysis in treatment of acute myocardial infarction

目的对比经皮冠状动脉介入术与尿激酶静脉溶栓治疗急性心肌梗死患者的临床效果。方法选取2015年9月~2016年11月在我院心内科住院治疗的急性心肌梗死患者148例。按照治疗方式的不同将入选者分为介入组与溶栓组,每组中74例。介入组患者给以经皮冠状动脉介入治疗,溶栓组患者实施尿激酶静脉溶栓治疗。比较两组患者治疗后2周、4周时LVESV、LVEDV、LVD、FS及EF指标改善情况。结果介入组患者的LVESV、LVEDV、LVD、FS及EF与溶栓组相比差异有统计学意义(P<0.05);介入组患者在治疗的第2周与第4周的LVESV、LVEDV、LVD比较差异无统计学意义(P>0.05),FS与EF比较差异有统计学意义(P<0.05);溶栓组患者在治疗的第2周与第4周的LVESV、LVEDV、LVD比较差异有统计学意义(P<0.05),FS与EF比较差异无统计学意义(P>0.05)。结论经皮冠状动脉介入术可显著的改善心肌梗死患者的血管再通率,改善左室功能。

Objective To investigate the clinical effect of percutaneous coronary intervention versus urokinase intravenous thrombolysis in the treatment of acute myocardial infarction. Methods A total of 148 patients with acute myocardial infarction who were hospitalized and treated in the Department of Cardiology in our hospital from September2015 to November 2016 were enrolled, and according to the treatment modality, they were divided into intervention group and thrombolysis group, with 74 patients in each group. The patients in the intervention group were given percutaneous coronary intervention, and those in the thrombolysis group were given urokinase intravenous thrombolysis. The two groups were compared in terms of the improvements in left ventricular end-systolic volume（LVESV）, left ventricular end-diastolic volume（LVEDV）, left ventricular diameter（LVD）, fractional shortening（FS）, and ejection fraction（EF） at weeks2 and 4 of treatment. Results There were significant differences in LVESV, LVEDV, LVD, FS, and EF between the intervention group and the thrombolysis group（P〈0.05）. From week 2 to week 4 of treatment, the intervention group had no significant changes in LVESV, LVEDV, and LVD（P〉0.05）, but had significant changes in FS and EF（P〈0.05）; the thrombolysis group had significant changes in LVESV, LVEDV, and LVD（P〉0.05）, but had no significant changes in FS and EF（P〉0.05）. Conclusion Percutaneous coronary intervention can significantly improve revascularization rate and left ventricular function in patients with myocardial infarction.