PCI及溶栓疗法对AMI患者的疗效及再灌注的影响

Influence of PCI and thrombolytic therapy on therapeutic effect and reperfusion of AMI patients

目的:比较经皮冠状动脉介入治疗(PCI)及溶栓治疗对急性心肌梗死(AMI)患者的疗效及再灌注的影响。方法:选择2013年1月~2016年12月我院收治的AMI患者118例作为研究对象,并被分为溶栓组(38例)及PCI组(80例),比较两组疗效、心功能及再灌注指标。结果:与溶栓组比较,PCI组总有效率(84.21%比97.50%)显著升高,而总不良事件率(18.42%比2.50%)显著降低(P均<0.01)。与治疗前比较,治疗后两组左室收缩末内径(LVESd)、PCI组的左室舒张末内径(LVEDd)显著降低,两组肌酸激酶同工酶(CK-MB)水平均显著升高,P均=0.001。与溶栓组比较,PCI组治疗后LVEDd[(32.45±2.21)mm比(29.86±3.96)mm]、LVESd[(49.85±1.32)mm比(46.86±2.34)mm]降低更显著,CK-MB水平[(389.74±2.74)ng/ml比(706.96±3.78)ng/ml]升高更显著,P均=0.001。结论:与溶栓治疗相比,PCI治疗AMI的效果更显著,改善患者心功能更显著,而且CK-M水平升高更显著,具有更好的临床价值。

Objective： To compare influence of percutaneous coronary intervention （PCI） and thrombolytic therapy on therapeutic effect and reperfusion in patients with acute myocardial infarction （AMI）. Methods： A total of 118 AMI patients treated in our hospital from Jan 2013 to Dec 2016 were enrolled. They were divided into thrombolysis group （n = 38） and PCI group （n = 80）. Therapeutic effect, cardiac function and reperfusion indexes were compared be- tween two groups. Results： Compared with thrombolysis group, there was significant rise in total effective rate （84.21% vs. 97.50%）, and significant reduction in total incidence rate of adverse events （18.42% vs. 2.50%） in PCI group, P〈O. 01 both. Compared with before treatment, there were significant reductions in left ventricular end-systolic dimension （LVESd） of two groups and left ventricular end-diastolic dimension （LVEDd） of PCI group, and significant rise in creatine kinase isoenzyme-MB （CK-MB） level of two groups after treatment, P = 0. 001 all. Compared with thrombotysis group after treatment, there were significant reductions in LVEDd [ （32.45 ± 2.21）mm vs. （29.86 ± 3.96） mm] and LVESd [ （49.85 ± 1.32） mm vs. （46. 86 ± 2.34） mm], and significant rise in CK- MB level [ （389.74 ± 2.74） ng/ml vs. （706. 96 ± 3.78） ng/ml] in PCI group, P--0. 001 all. Conclusion.. Compared with thrombolytic therapy, PCI possesses more significant therapeutic effect on AMI. It can more significantly im- prove patient＇s cardiac function, and rise CK-MB level, which has better clinical value.