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目的 :比较直接经皮冠状动脉腔内成形术 (PTCA)与静脉溶栓治疗急性心肌梗塞 (AMI)的疗效。方法 :96例AMI患者 ,53例接受静脉溶栓治疗 ,43例接受直接PTCA治疗。结果 :溶栓治疗组梗塞相关血管 (IRA)再通率为 64 .1 % ,直接PTCA组的IRA开通率为 93 .0 % ,溶栓组存活患者的LVEF为 (53 .9± 9.4) % ,急诊PTCA组为 (59.4± 1 1 .2 ) % ,两组差异显著 (P <0 .0 5)。两组的病死率分别为 1 5 .1 % (8/ 53)和 7.0 % (3/ 4 3) ,两组差异无显著性 (P >0 .0 5)。溶栓组出血发生率和出血程度较直接PTCA组严重 ,而且心脏破裂的机会增多 ,但无显著差异 (P >0 .0 5)。结论 :直接PTCA治疗AMI可以更加安全、充分有效地开放IRA ,保存心脏功能。
Objective: To compare the efficacy of direct percutaneous transluminal coronary angioplasty (PTCA) and intravenous thrombolysis in the treatment of acute myocardial infarction (AMI). Methods: Ninety-six AMI patients, 53 received intravenous thrombolysis and 43 received direct PTCA. Results: The rate of IRA was 64.1% in the thrombolytic group, 93.0% in the direct PTCA group, and (53.9 ± 9.4)% in the thrombolytic group (59.4 ± 11.2%) in the emergency PTCA group, with significant difference between the two groups (P <0.05). The mortality rates of the two groups were 15.1% (8/53) and 7.0% (3/4 3) respectively, with no significant difference between the two groups (P> 0.05). The incidence of hemorrhage and bleeding in the thrombolytic group were more severe than those in the direct PTCA group, and the chances of heart rupture were increased, but there was no significant difference (P> 0.05). Conclusion: Direct PTCA for AMI can be more safe, fully and effectively open IRA, save heart function.