急性ST段抬高型心肌梗死行急诊PCI与溶栓治疗120例疗效分析

Evaluation and Analysis of the Efficacy of Direct PCI and Thrombolysis in 120 Patients with ST-segment Elevation Myocardial Infarction

目的观察急性ST段抬高型心肌梗死(STEMI)患者行急诊经皮冠状动脉介入术(PCI)与同期行溶栓治疗的疗效。方法选择潍坊市人民医院急诊内科2013年7月~2014年10月首诊的STEMI患者120例,发病时间均在12h以内,其中行急诊PCI治疗80例,与同期溶栓治疗STEMI 40例进行疗效对比,比较两组患者的一般临床特点、血运重建率、心血管不良事件发生率、再灌注治疗后30d及90d的左室射血分数(LVEF)、住院病死率等。结果两组患者的一般临床特点无明显差异,急诊直接PCI组的血运重建率、心血管不良事件发生率、LVEF、住院病死率等均明显优于溶栓治疗组。结论对于STEMI患者在治疗条件允许的前提下应首选急诊PCI,急诊PCI治疗STEMI的总体效果及预后都明显优于溶栓治疗组。

Objective To evaluate the efficacy of emergency PCI and concurrent thrombolytic therapy in patients with acute ST-segment elevation myocardial infarction（STEMI）.Methods One hundred and twenty STEMI patients attending the first method selected from the emergency internal medicine of weifang people ＇s hospital from July2013 to October 2014,the onset time was less than 12 h,80 cases underwent emergency PCI treatment,compared with thrombolytic therapy in 40 patients with STEMI,comparison of two groups of patients with clinical characteristics,revascularization rate,the incidence of adverse cardiovascular events after reperfusion therapy,30 d and 90 d of the left ventricular ejection fraction（LVEF）,hospital mortality.Results There were no significant differences in general clinical characteristics between the two groups.The emergency direct PCI group was significantly better than the thrombolytic therapy group in the rate of revascularization,incidence of adverse cardiovascular events,LVEF,hospital mortality,and so on.Conclusion For patients with STEMIF,the first choice of emergency treatment should be PCI,emergency PCI in the treatment of acute ST segment elevation myocardial infarction overall effect and long-term prognosis are significantly better than the thrombolytic therapy group.