冠状动脉介入或联合溶栓治疗急性心肌梗死的临床研究

Emergency percutaneous coronary intervention or join with thrombolytic therapy in acute myocardial infarction:Compared with thrombolytic therapy

目的探讨急诊冠状动脉介入治疗 (PCI)或联合溶栓治疗对急性心肌梗死 (AMI)的临床疗效。方法 对 3 3例AMI患者行直接PCI治疗 (PCI组 ) ,3 6例AMI患者在溶栓治疗的同时行直接PCI治疗 (溶栓 +PCI组 ) ,42例AMI患者行溶栓治疗 (溶栓组 ) ,比较各组住院和随诊期间的情况。结果 PCI组住院天数为 (9.3± 4.1)天 ,左心室射血分数 (LVEF)为 (4 5 .1± 4.2 ) % ;随诊期间 ,心绞痛发作 2例 ,择期再次PCI 2例。溶栓 +PCI组住院天数为 (9.2± 4.0 )天 ,LVEF为 (4 7.2± 4.1) % ;随诊期间 ,心绞痛发作 1例 ,择期再次PCI 1例。溶栓组住院天数为 (14 .0± 7.3 )天。LVEF为 (4 1.8± 6.4) % ;随诊期间 ,心绞痛发作 15例 ,择期PCI 14例。结论 AMI直接PCI或溶栓 +PCI可降低AMI的住院死亡率 (P <0 .0 1) ,缩短住院天数 (P <0 .0 5 ) ,有效保护心脏功能 (P <0 .0 1)。

Objective To compare the effect of emergency percutaneous coronary intervention(PCI)and thrombolytic therapy in acute myocardial infarction(AMI).Methods 33 cases of AMI were treated by emergency PCI and 36 cases of AMI were treated by emergency PCI and thrombolytic therapy while 42 cases of AMI were treated by thrombolytic therapy.We then compared the clinical effect among three groups both in hospital and the follow-up period.Results In the emergency PCI group,the average staying in hospital was(9.3±4.1)d,and the left ventricular ejection fraction(LVEF)was(45.1± 4.2)%.During the follow-up period,2 cases of angina pectoris occurred again and 2 case accepted the treatment of selective PCI.In the emergency PCI and thrombolytic therapy group,the average staying in hospital was(9.2±4.0)d,and the LVEF was(47.2±4.1) %.During the follow-up period,1 cases of angina pectoris occurred again and 1 case accepted the treatment of selective PCI.In the group of thrombolysis, the average staying in hospital was(14.0±7.3)d,and the LVEF was(41.8±6.4)%.During the follow-up period of 4～12 months,15 cases of angina pectoris occurred again and 14 cases accepted the treatment of selective PCI.Conclusion The treatment of emergency PCI or emergency PCI and thrombolytic therapy can reduce the ratio of sudden death and the days in-hospital(P<0.05),protect the ventricular function effectively(P<0.01).