摘要
目的 对比直接冠状动脉内介入治疗 (PCI)及静脉尿激酶 (UK)溶栓治疗对急性心肌梗死 (AMI)的临床疗效。方法 2 5 4例AMI患者 ,180例接受静脉溶栓治疗 ,74例接受PCI治疗。比较两组住院期间临床结果及超声心动图 (UCG)结果。结果 直接PCI组 :IRA开通率 (95 .9% )高于UK组 (6 1.2 % ) ,P <0 .0 5 ;心衰发生率12 .1% ,严重心律失常发生率 8.1% ,心源性休克发生率 2 .7% ,病死率 2 .7% ,均低于PCI组 (分别为 2 5 .0 % ,2 0 .0 % ,10 .0 % ,11.1% ,两组比较有显著差异P <0 .0 5 )。UCG检查 :室壁矛盾运动发生率直接PCI组为 2 .7% ,低于UK(12 .7% ) ,P <0 .0 5 ;而左室射血分数 (LVEF) (% )直接PCI组为 5 6 .8± 8.3,高于UK组 5 1.2± 10 .4 ,两组比较P<0 .0 5。而两组中出血率、再发心绞痛率和再闭塞率无明显差别 (P >0 .0 5 )。结论 直接PCI治疗AMI与UK治疗相比能更有效开放IRA ,保护心功能 ,减少心衰及心脏恶性事件发生率和病死率 ,改善心肌梗死患者预后。
Objective To compare the healing effect of direct percutaneous coronary intervention(PCI) and thrombolytic therapy (Urokinase,UK) in acute myocardial infarction(AMI).Methods Among two hundred and fifty four consecutive patients with AMI,180 cases were treated with thrombolytic therapy(UK), but 74 cases were treated with direct PCI.We compared the results of clinic effects and ultrasonic cardiograpa(UCG) in hospital. Results In direct PCI group,the recanalizing rate of infarct related artery (IRA) was significantly higher than that in UK group (95.9%vs.61.2%), P<0.05; but the incidences of heart failure?malignant arrhythmia?cardiogenic shock and mortority in PCI group were lower than those in UK group .(12.1% vs.25.0%, 8.1% vs.20.0%, 2.7% vs.10.0%, 2.7% vs.11.1%; P<0.05, respectively). The UCG examination showed that the rate of dyskinesia in PCI group was significantly lower than that in UK group (2.7% vs.12.7%, P<0.05). while LVEF(%) in PCI group was significantly highter than that in UK group 56.8±8.3 vs. 51.2±10.4, P<0.05. There were no significant differences in the rate of bleeding ,angina pectoris and repeat implosion between these tow group.Conclusion This study showed that direct PCI is more effective than thrombolytic therapy in preserving cardiac function , it reduced the rate of heart failure and mortality, improve the prognosis of AMI.
出处
《宁夏医学杂志》
CAS
2004年第6期329-331,共3页
Ningxia Medical Journal
