急性心肌梗死溶栓治疗后临床指标与冠状动脉造影判断冠状动脉再通的效能对比研究  

Comparative Study on the Efficiency of Clinical Indicators and Coronary Angiography in Judging the Coronary Recanalization after Thrombolytic Therapy for Acute Myocardial Infarction

作　　者：付敏[1] 师聪红[1] 张宝红[1] 王娟[1] 田斌[1] 

机构地区：[1]包头市第四医院心内科,内蒙古包头014030

出　　处：《医学综述》2014年第17期3220-3221,共2页Medical Recapitulate

摘　　要：目的探讨急性心肌梗死溶栓治疗后临床指标的诊断效能,寻求有效的诊断方式。方法选取2011年1月至2013年1月包头市第四医院心内科诊断为急性心肌梗死的患者100例,溶栓治疗后,均采用临床治疗指标以及冠状动脉造影诊断溶栓后再通的效果。以临床治疗结果为指标,采取常规治疗方式和冠状动脉造影方式。比较两种诊断方式的诊断结果,以冠状动脉造影检查为标准,计算临床指标的灵敏度、特异度;以及采用冠状动脉造影检查方式的并发症的发生情况。结果冠状动脉造影检查与常规治疗方式的溶栓后再通率比较,差异无统计学意义(P>0.05)。冠状动脉造影检测的灵敏度与临床常规指标诊断的灵敏度比较,差异无统计学意义(P>0.05),冠状动脉造影检测的特异度与临床常规指标诊断的特异度比较,结果具有统计学意义(P<0.05)。冠状动脉造影检查患者血肿形成、心律失常、动脉内膜损伤等并发症的发生率分别为2.0%、1.0%、1.0%。结论临床指标对于急性心肌梗死患者溶栓治疗后再通情况的判断有较高的判断意义,且为无创检查,操作简单方便,值得临床推广应用。Objective To investigate the diagnostic efficiency of clinical indicators （CI） after thrombolytic therapy for acute myocardial infarction,and explore effective diagnostic ways. Methods A total of 100 cases of patients with acute myocardial infarction admitted in Baotou Fourth Hospital from Jan. 2011 to Jan. 2013 were treated with thrombolytic therapy ,after that, CI and coronary angiography（CA） were both used to diagnose therecanalization＇s effect. The results of the conventional treatment and coronary angiography were compared,and the sensitivity, specificity of CI were calculated according to the result of CA, moreover, the incidence of complications after CA examination was also evaluated. Results The difference between the thrombolytie reeanalization rates gained from CA examination and the conventional treatment was not statistically significant（ P 〉 0.05 ）. The difference between the sensitivity of CA examination and that of routine diagnostic CI was not statistically significant（ P 〉 0. 05 ）. The difference between the specificity of CA examination and that of conventional CI was statistically significant （ P 〈 0. 05 ）. Complication incidence rates of hematoma formation, arrhythmia, and arterial intimae injury after CA examination were 2.0%, 1.0%, 1.0%. Conclusion CI play important role in diagnose the thrombolytic recanalization, which come from noninva- sire examination that easy to operate, and is worthy of clinical application.

关 键 词：急性心肌梗死 溶栓 临床指标 冠状动脉造影 

分 类 号：R542.22[医药卫生—心血管疾病]