溶栓及PTCA治疗急性心肌梗塞92例临床分析  

Clinical analysis of 92 cases of thrombolysis and percu taneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction

作　　者：钱学贤[1] 刘映峰[1] 傅向阳[1] 贺江南[1] 叶文胜[1] 李志梁[1] 丁明学[1] 唐晓明[1] 赵霞[1] 

机构地区：[1]第一军医大学珠江医院心内科

出　　处：《岭南心血管病杂志》1996年第2期5-8,61,共5页South China Journal of Cardiovascular Diseases

摘　　要：本文总结１９９１年８月至１９９６年４月应用溶栓及ＰＴＣＡ治疗ＡＭＩ９２例，男７６例，女１６例，年龄４６～７０岁之间，平均年龄６０．２±１０．５岁。治疗分为：①冠状动脉内输注尿激酶（ＩＣＵＫ）组３２例；②静脉输注尿激酶（ＩＶＵＫ）组４１例；③经皮冠状动脉腔内成形（ＰＴＣＡ）组１９例。全组再通６９例，总再通率为７５．０％，ＩＣＵＫ组、ＩＶＵＫ组、ＰＴＣＡ组再通率分别为７５．０％、６５．７％和９４．７％三组再通率比较有显著差异。三组患者近期预后比较：全组９２例，死亡９例，死亡率９．７８％，８例发生于梗塞血管未通者，１例发生于血管再通者。ＩＣＵＫ组３２例，死亡３例（９．３７％），发生心功能不全８例（２５．０％）；ＩＶＵＫ组４１例，死亡５例（１２．０％），发生心功能不全１１例（２６．８３％）；ＰＴＣＡ组１９例，死亡１例，死亡率为５．２６％，ＰＴＣＡ组无心功能不全者。From August 1991 to April 1996, 92 patients (76 males, 16 females) aged between 46-70 (60. 2±10. 5 ) with acute myocardial infarction(AMI) were treated with thrombolysis and/or precutaneous transluminal coronary angioplasty (PTCA). (1 ) 32 cases treated with intracoronary injection of urokinase(ICUK ); (2 ) 41 cases with intraveneous infuion of urokinase (IVUK ), and (3) 19 cases with PTCA. Of all the cases. 69 patients got coronary repatency with a total repatency rate of 75.0%. The repetancy rates were significant different amoung these Three groups, with a repatency rate of 75.0% in ICUK, 65 .7% in IVUK, and 94.7% in PTCA, respectively. In all the 92 cases. 9 patients were died (9. 78%, 9/92), with & cases without infarcted coronary repatency and the other one case with coronary repateney. In the 32 cases with ICUK, 3 cases were died(9. 37% ), and 8 cases (25. 0%)developed to cardiac insufficency. In the 41 cases with IVUK, 5 cases were died (12. 0% ), and 11 (26. 83 % ) cases developed to cardiac insufficency. While in the 19 cases with PTCA, only on case was died(5 .26% ), and no patient in this group underwent cardiac insufficency.

关 键 词：急性心肌梗塞(AMI) 静脉溶栓(IVUK) 冠状动脉内溶栓(ICUK) 尿激酶(UK) 经皮穿刺冠状动脉腔内成形术(PTCA) 

分 类 号：R542.22[医药卫生—心血管疾病]