论文部分内容阅读
比较直接经皮冠状动脉腔内成形术 (PTCA)与重组组织型纤溶酶原激活剂 (rt- PA)静脉溶栓治疗急性心肌梗死 (AMI)的疗效。方法 :38例患者中 2 0例接受 rt- PA药物溶栓治疗 ,18例接受直接PTCA治疗 ,观察两组之间梗死相关血管 (IRA)的再通率、左室射血分数 (L VEF)、再梗发生率及病死率等。结果 :溶栓组 IRA再通的患者有 15例 ,再通率 75 .0 % ,直接 PTCA组 IRA成功再通的患者有 18例 ,再通率10 0 .0 % ,两组差异有显著性意义 (P<0 .0 5 ) ;溶栓组 L VEF为 0 .5 0± 0 .13,直接 PTCA组 L VEF为 0 .5 8±0 .10 ,两组差异有显著性意义 (P<0 .0 5 ) ;再次心肌梗死发生率两组分别为 10 .0 %与 0 .0 % (P>0 .0 5 ) ;住院病死率两组分别为 5 .3%与 5 .6 % (P>0 .0 5 )。结论 :直接 PTCA比静脉溶栓更充分有效地开通 IRA,改善患者心功能。
To compare the efficacy of direct percutaneous transluminal coronary angioplasty (PTCA) and recombinant tissue plasminogen activator (rt-PA) in the treatment of acute myocardial infarction (AMI). Methods: Twenty-eight of 38 patients received rt-PA drug thrombolysis and 18 received direct PTCA. The recanalization rate of infarct-related blood vessel (IRA), left ventricular ejection fraction (LVEF) , The incidence of reinfarction and mortality. Results: In the thrombolytic group, there were 15 cases with recanalization of IRA and the recanalization rate was 75.0%. There were 18 recanalization cases in the direct PTCA group and the recanalization rate was 100.0%. There was significant difference between the two groups (P <0.05). The L VEF in the thrombolytic group was 0.55 ± 0.13, the L VEF in the direct PTCA group was 0.58 ± 0.10, the difference was significant (P < 0.05). The incidence of recurrent myocardial infarction was 10.0% and 0. 0% respectively (P> 0.05). The in-hospital mortality was 5.3% and 5.6% P> 0 .0 5). Conclusion: Direct PTCA is more effective than intravenous thrombolysis to open IRA and improve cardiac function.