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目的观察急性ST段抬高型心肌梗死(STEMI)直接PCI与溶栓后PCI的效果及对预后的影响。方法收集STEMI患者共101例,根据转运时间的长短分为两组:<90 min组(A组)51例,预计转运时间>90 min(B组)50例。A组患者急诊转入后直接行PCI治疗,B组则先溶栓,再转入该院行PCI治疗。比较两组住院期间、发病后1个月、发病后6个月、发病后1 a的主要心血管不良事件发生情况。结果两组单支病变、双支病变、三支及左主干病变对比无统计学差异(P≥0.05);两组D-to-B时间比较无统计学差异。住院期间、发病后1个月、6个月和1 a的随访,两组患者的主要心血管不良事件比较无统计学差异(P>0.05)。结论急性ST段抬高型心肌梗死发病6 h内行直接PCI与溶栓后PCI疗效相当,出血事件两组无显著差别。
Objective To observe the effect of direct thrombolysis and thrombolysis after acute ST-segment elevation myocardial infarction (STEMI) on prognosis. Methods A total of 101 STEMI patients were collected and divided into two groups according to the length of transit time: 51 patients in group A (90 minutes) and 50 patients (group B) in transit time> 90 minutes. Patients in group A underwent emergency PCI immediately after PCI, while patients in group B received thrombolytic therapy before PCI. The incidence of major cardiovascular adverse events during hospitalization, 1 month after onset, 6 months after onset, and 1 year after onset were compared between the two groups. Results There was no significant difference between the two groups of single vessel disease, double vessel vessel disease, triple vessel and left main vessel disease (P> 0.05). There was no significant difference in D-to-B time between the two groups. There were no significant differences in major adverse cardiovascular events between the two groups during hospitalization, 1 month, 6 months and 1 year after onset of illness (P> 0.05). Conclusion The efficacy of direct PCI and PCI after thrombolysis within 6 hours after onset of acute ST-elevation myocardial infarction is comparable. There is no significant difference between the two groups in the incidence of bleeding.