溶栓后早期PCI与急诊PCI治疗STEMI临床研究  

Clinical observation of acute ST elevation myocardial infarction patients with Post-fibrinolysis Angioplasty and primary angioplasty

作　　者：白洁[1] 卢竞前[2] 杨锋[2] 吕云 张荣华[4] 田青[2] 孙琳 李易[1] 

机构地区：[1]重庆医科大学附属大学城医院,重庆400000 [2]云南省昆明市第一人民医院,云南昆明650034 [3]云南省圣约翰心脏病医院,云南昆明650028 [4]云南省个旧市人民医院,云南个旧661400 [5]云南省第三人民医院,云南昆明650011

出　　处：《吉林医学》2012年第20期4272-4275,共4页Jilin Medical Journal

摘　　要：目的:观察溶栓后早期PCI治疗急性ST段抬高型心肌梗死的临床疗效及安全性。方法:按照实际救治情况将212例STEMI患者分为溶栓后早期PCI(102例)和急诊PCI组(108例),随访30 d,对比两组梗死相关血管TIMI血流及TIMI心肌灌注(TMP)情况、左心室功能及复合终点和出血情况。结果:两组基线无差异,溶栓后早期PCI组冠脉造影时TIMI 3级率明显高于急诊PCI组(67%∶13.7%,P<0.001)开通率为41/42,介入完成后两组TIMI血流3级率差异无统计学意义,但溶栓后PCI组TMP3级率仍显著高于急诊PCI组(50%∶25.3%,P=0.03);30 d随访两组左室射血分数、复合终点事件无差异。结论:溶栓后早期PCI治疗安全有效,不增加出血并发症,值得进一步临床探索。Objective To observe the treatment effect and safety of the STEMI patients with Post - fibrinolysis Angioplas- ty. Method 212 STEMI patients were divided into 2 groups according to the clinical therapy. One group accepted Post - fibrinolysis Angio- plasty （n = 104）, the other group took Primary Angioplasty （n = 108 ）. Compared TIMI flow, TIMI myocardial perfusiun, left ventricular function and bleeding event and compound endpoints between two groups in infusing the infarction related artery （IRA） after 30 days follow up. Results The baselines of two group were similar, and the TIMI 3 grade were higher in Post- fibrinolysis Angioplasty than Primary An-gioplasty （67% vs 13.7% ,P 〈 0. 001 ）, after PCI, the TIMI 3 grade was similar in two group, but TMP 3 grade was higher in Post -fibrinol- ysis Angioplasty than Primary Angioplasty（50% VS 25.3% ,P =0. 03） ,follow up data were similar in left ventricular function and bleeding event and the compound endpoints between two groups. Conclusion Post -fibrinolysis Angioplasty is a safe, effective and economical treat- ment method and this therapeutic methods will be worthy for deeply search to treat AMI in clinic.

关 键 词：心肌梗死 介入治疗 溶栓 

分 类 号：R542.22[医药卫生—心血管疾病]