急性心肌梗塞冠状动脉内支架治疗与药物溶栓治疗比较

Comparison of clinical efficancy of primary coronary tenting and thrombolysis in actue myocardial infarction during hospitalization in my hospital

目的 :比较直接冠状动脉内支架治疗与药物溶栓治疗急性心肌梗塞患者住院期间的临床效果。方法 :在 48例急性心肌梗塞 (AMI)患者中 ,2 7例接受直接冠状动脉内支架治疗 ,2 1例接受药物溶栓治疗。结果 :冠状动脉内支架植入组血管开通率为 92 .6% ,LVEF为 5 7.5 9± 5 .96,溶栓组血管再通率为 61.9% ,左室射血分数 (LVEF)为 5 1.76± 6.2 8;两组比较均有显著性差异 (p <0 .0 5 )。住院期间冠状动脉内支架植入组再发心肌缺血、再发心肌梗死率和死亡率较溶栓组有减小趋势 ,但无显著差异 (p >0 .0 5 )。结论 :AMI介入治疗 (尤其是冠状动脉内支架植入术 )较溶栓治疗可使梗塞相关血管 (IRA)充分开通 ,更好改善心功能。

Objective:To compare the clinical efficancy of primary coronary tenting with thrombolytic therapy in the treatment of acute myocardial infarction (AMI) during hospitalization. Methods: Twenty-seven patients underwent primary coronary tenting, twenty-one patients underwent intravenous thrombolytic therapy. Results: The recanalizing rate of infarct related artery (IRA) in patients with thrombolytic therapy was 61.9%, while in those with primary coronary tenting was 92.6%. Cardiac function (left ventricular ejection fraction, LVEF) was 51.76±6.28 in the patients with thrombolytic therapy, while in those with primary coronary tenting was 57.59±5.96. There were significant differences between two groups(P<0.05). Conclusion: The present study showed that in a highly selected cohort with successful IRA recanalization, primary coronary tenting is more effective than thrombolytic therapy in preserving cardiac function after AMI.