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目的 探讨基层医院急诊冠脉介入治疗(PCI)急性心肌梗死(AMI)的价值。方法 2002 年1月至2004年1月,对82例急诊收治的ST段抬高性AMI患者,其中42例行急诊PCI,对照组40 例只给予常规抗凝或抗血栓治疗。结果 42例PCI,成功率100%。(1)6 h内胸痛缓解率明显高于对照组,6 h内ST段恢复率显著高于非PCI组。住院心力衰竭、死亡率明显少于对照组。(2)6 个月行心脏彩超检查,EF、LV、LA显著优于对照组,E/A<1的例数少于对照组。(3)6 个月内冠脉事件(心绞痛、再发心肌梗死、心力衰竭、死亡)发生率明显少于非PCI组。结论 AMI后行急诊PCI对近期和后期都有重要保护意义,同样适合于基层医院开展。
Objective To investigate the value of acute coronary intervention (PCI) acute myocardial infarction (AMI) in primary hospital. Methods From January 2002 to January 2004, 82 patients with acute ST-segment elevation AMI were enrolled in this study. Forty-two patients underwent emergency PCI, while 40 patients in the control group received routine anticoagulation or antithrombotic therapy. Results 42 cases of PCI, the success rate of 100%. (1) The remission rate of chest pain within 6 h was significantly higher than that of control group, and the recovery rate of ST segment within 6 h was significantly higher than that of non-PCI group. In-hospital heart failure, mortality was significantly less than the control group. (2) After 6 months’ cardiac echocardiography, EF, LV and LA were significantly better than the control group, and the number of E / A <1 was less than that of the control group. (3) The incidence of coronary events (angina pectoris, recurrent myocardial infarction, heart failure, death) within 6 months was significantly less than that of non-PCI group. Conclusions Emergency PCI after AMI has important protective significance both in the near and the late stages, and is also suitable for primary hospitals.