急诊介入治疗与静脉溶栓治疗急性心肌梗死近期疗效比较

Comparison of emergency percutaneous coronary intervention and intravenous thrombolysis for acute myocardial infarction

目的 比较急诊介入治疗 (percutaneouscoronaryintervention ,PCI)与静脉溶栓治疗 (thrombolysistherapy ,TT)急性心肌梗死 (acutemyocardialinfarction ,AMI)近期疗效。方法 回顾性比较 39例急诊PCI治疗、58例TT治疗的近期疗效。Logistic回归分析性别、年龄、梗死相关冠状动脉 (infarct relatedcoronaryartery,IRCA)等 1 5个因素对PCI成功、导管室事件的影响。结果 急诊PCI治疗AMI 30天病死率 2 .6 %、血管再通率 94.9% ,症状不缓解率 0 % ,心力衰竭发生率 7.7%。TT组治疗AMI 30天病死率 1 5 .5 %、血管再通率 66 .7% ,症状不缓解率 6 .9% ,心力衰竭发生率 8.6 %。结论 PCI治疗AMI住院病死率低、成功率高、并发症发生率低 ,近期疗效优于TT治疗。IRCA是PCI成功。

Objective To compare the 30 d efficacy of emergency percutaneous coronary intervention(PCI)and thrombolysis therapy(TT) for acute myocardial infarction(AMI).Methods Out of 97 patients admitted to our department for acute myocardial infarction, 39 received emergency PCI; 58 received TT. The clinical benefit in different treatment was compared. Using catheterization laboratory events and reperfusion as evaluating variable to analyze the influence of several factors such as sex, age, infarct related coronary artery(IRCA) etc. Results In emergency PCI group, in hospital mortality rate is 2.6 %; patency rate 94.9 %, syndrom unremission rate 0%, heart failure rate 7.7 %. In TT group, in hospital mortality rate is 15.5 %; patency rate 66.7 %, syndrome unremission rate 6.9 %, heart failure rate 8.6 %. Conclusion Emergency PCI for AMI has low in hospital mortality, high reperfusion, low complication, and is better than intravenous thrombolysis in short term efficacy. IRCA is the major influential factor of the reperfusion and catheterization laboratory events.