急性心肌梗死急诊早期溶栓与介入治疗的效果对比

Comparison of effect of early thrombolysis and interventional therapy in acute myocardial infarction

目的对比急性心肌梗死患者在急诊中接受早期溶栓与介入治疗的效果。方法60例急诊科收治的急性心肌梗死患者,根据随机数字表法分为对照组和观察组,每组30例。对照组入院后接受早期溶栓治疗,观察组入院后接受介入治疗。比较两组的再灌注成功率,心血管事件发生率,治疗前后左室射血分数、左室舒张末期内径、肌酸激酶水平,出血发生率及复发率。结果观察组的再灌注成功率96.67%高于对照组的73.33%,差异具有统计学意义(P<0.05)。观察组的心血管事件发生率6.67%低于对照组的36.67%,差异具有统计学意义(P<0.05)。治疗后,观察组的左室射血分数(52.82±6.27)%、左室舒张末期内径(54.79±5.31)mm均大于对照组的(42.07±4.53)%、(43.35±4.66)mm,肌酸激酶(183.26±31.25)U/L低于对照组的(277.18±45.37)U/L,差异具有统计学意义(P<0.05)。两组的出血发生率对比,差异无统计学意义(P>0.05);观察组的复发率3.33%低于对照组的20.00%,差异具有统计学意义(P<0.05)。结论在急性心肌梗死患者的急诊治疗中,应用介入治疗效果确切,可以提高再灌注成功率,改善患者的心功能,且能降低心血管事件及出血风险,还能降低复发率。

Objective To compare the effect of early thrombolysis and interventional therapy in acute myocardial infarction.Methods A total of 60 patients with acute myocardial infarction admitted to the emergency department were divided into a control group and an observation group according to the random numerical table,with 30 cases in each group.The control group received early thrombolysis after admission,and the observation group received interventional therapy after admission.Both groups were compared in terms of reperfusion success rate,incidence of cardiovascular event,left ventricular ejection fraction,left ventricular end-diastolic diameter,creatine kinase level,incidence of bleeding,and recurrence rate.Results The reperfusion success rate was 96.67%in the observation group,and the difference was not statistically significant compared with 73.33%in the control group(P<0.05).The incidence of cardiovascular events in the observation group was 6.67%,which was lower than 36.67%in the control group,and the difference was statistically significant(P<0.05).After treatment,the left ventricular ejection fraction(52.82±6.27)%and left ventricular end-diastolic diameter(54.79±5.31)mm in the observation group were greater than(42.07±4.53)%and(43.35±4.66)mm in the control group;the creatine kinase(183.26±31.25)U/L in the observation group was lower than(277.18±45.37)U/L in the control group;the differences were statistically significant(P<0.05).The incidence of bleeding in the two groups was compared,and the difference was not statistically significant(P>0.05).The recurrence rate 3.33%in the observation group was lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion In the emergency treatment of patients with acute myocardial infarction,interventional therapy can improve the reperfusion success rate,improve their cardiac function,reduce the risk of cardiovascular events and bleeding,and lower the recurrence rate.