老年急性心肌梗死直接介入治疗与溶栓治疗的临床研究  

Clinical Efficacy Evaluation of Direct Percutaneous Coronary Intervention and Thrombolytic Therapy in Aged Patients with AMI

作　　者：卓建伟[1] 

机构地区：[1]福建省莆田学院附属医院心内科,351100

出　　处：《实用心脑肺血管病杂志》2010年第12期1776-1777,共2页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨急诊冠状动脉介入治疗(PCI)与静脉溶栓治疗对老年急性心肌梗死(AMI)患者的近期疗效。方法 65例≥60岁的ST段抬高的AMI患者,31例接受急诊PCI治疗,34例接受静脉溶栓治疗,比较两种治疗方法对患者的临床近期效果。结果溶栓组梗死相关血管(IRA)再通率为58.8%,直接PCI组IRA再通率为96.8%;6个月时左室射血分数(LVEF)溶栓组为(40.2±6.3)%,直接PCI组为(53.8±6.7)%。出血并发症、住院期间病死率、再发心绞痛和主要心脏事件发生率,溶栓组明显高于直接PCI组。溶栓组平均住院时间为8.5d,PCI组平均住院时间为18.5d。结论对老年AMI患者,急诊PCI治疗更能尽快、及时有效地开通梗死相关动脉,挽救濒死心肌,改善左室功能,降低病死率。Objective To evaluate the clinical efficacy of direct percutaneous coronary intervention (PCI) and thrombolytic therapy aged patients with acute myocardial infarction(AMI).Methods Sixty-five aged patients(age≥60 years old) with AMl were divided into direct PCI treatment group (n=31) and thrombolytic therapy group (n=34).The clinical outcomes between the two group were compared.Results The infarct-related artery (IRA) reperfusion rate in the patients with intravenous thrombolysis was 58.8%;While in the PCI group the IRA reperfusion rate was 96.8%.There was significant differences in left ventricular ejection farction (LVEF) in six months after AMI between thrombolytic group and the PCI geroup(40.2%±6.3% vs 53.8%±6.7%,P<0.05).The ratio was higher in thrombelytic group than in PCI group among complicated hemorrhage rate.The average days staying inhospital was less in the PCI group than in the thrombolytic group.Conclusion Direct emergency PCI in elder oatuebts with AMI could rapidly and efficaeiously reperfuse IRA,rescue dying myoeardium,improve left ventrieular function,and reduce the mortality of AMI in the aged patients.

关 键 词：急性心肌梗死 经皮冠状动脉腔内成形术 血栓溶解疗法 

分 类 号：R54[医药卫生—心血管疾病]