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直接经皮冠状动脉腔内成形术与溶栓治疗急性心肌梗塞近期疗效分析 |
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胡大一 崔亮 魏妤 陈方 王乐丰 赵文淑 顼志敏
吴雅枫 李田昌 贾三庆 杨明 王明生 陈瑾 王红石
【摘要】 目的 比较直接经皮冠状动脉腔内成形术(PTCA)与药物溶栓治疗急性心肌梗塞(AMI)患者住院期间的临床效果。方法 在109例AMI患者中, 45例患者接受直接PTCA治疗, 64例患者接受药物溶栓治疗。 结果 溶栓组梗塞相关血管(IRA)再通的患者有48例, 再通率为75%; 直接PTCA组IRA成功开通的患者有44例,成功率为97.8%。 住院期间左室射血分数(EF)溶栓组为54.1±13.2,直接PTCA组为64.2±10.1, 差异有显著性(P<0.05); 病死率分别为6.3%和2.2%，两组间差异无显著性(P>0.05)。进一步分析溶栓再通组与直接PTCA成功组的临床疗效, 前者因再闭塞或缺血发作行择期PTCA的比率明显高于直接PTCA组(27.1% vs 0;P<0.05), 但直接PTCA组左室EF仍显著高于溶栓再通组(64.8±9.8 vs 55.9±12.6 P<0.05)。 住院期间再发梗塞, 心肌缺血事件和心力衰竭例数溶栓再通组都有增加的趋势,但差异无显著性(P>0.05)。结论 直接PTCA与溶栓治疗AMI患者, 前者可使IRA充分有效地开通,能更好地改善患者心功能。
【关键词】 血管成形术, 经腔, 经皮冠状动脉 血栓溶解疗法
Comparison of the clinical effcacy of primary angioplasty and thrombolysis in acute myocardial infarction during hospitalization
Hu Dayi, Cui Liang, Wei Yu,et al. The Institute of Cardiovascular Diseases, The Heart Center, Beijing Red Cross Chaoyang Hospital, Capital University of Medical Sciences, Beijing 100020
【Abstract】 Objective To compare the clinical efficacy of primary angioplasty with thrombolytic therapy in the treatment of acute myocardial infarction (AMI) during hospitalization. Methods One hundred and nine consecutive patients with a first AMI underwent either intravenous thrombolytic therapy (64 patients) or primary angioplasty (45 patients). Cardiac function (left ventricular ejection fraction, LVEF) was assessed during hospitalization by echocardiography.Results The recanalizing rate of infarct related artery (IRA) in patients with thrombolytic therapy was 75%, while in those with primary angioplasty was 97.8%. There were no significant differences in age, risk factors, time from onset of symptom to hospital presentation and infarct location between the two but apparent differences were found in LVEF (54.1±13.24 vs 64.17±10.12, P< 0.05).In particular, in those patients with successful patency of IRA, the LVEF in the latter was s[1] [2] [3] 下一页
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