rtPA静脉溶栓与直接PTCA冠脉支架术治疗急性心肌梗死的临床疗效观察  

Efficacy of Percutaneous Transluminal Coronary Angioplasty and Thrombolytic Therapy in Acute Myocardial Infarction

作　　者：郭绪昆[1] 刘寅[1] 屈大展[1] 李丽华[1] 

机构地区：[1]天津市胸科医院,300192

出　　处：《天津医药》2002年第8期466-468,共3页Tianjin Medical Journal

摘　　要：目的:比较rtPA静脉溶栓与直接PTCA支架术治疗急性心肌梗死（AMI）的临床疗效。方法:156例AMI患者,rtPA静脉溶栓治疗72例,PTCA支架术84例,观察临床疗效。结果:IRA的再通率溶栓组56例（77％）,PTCA组84例（100％）,P<0.01。PTCA治疗降低了出血并发症、心绞痛发生率及再发心梗率。两组比较有显著性差异。LVEF溶栓组0.51±0.18,PTCA组0.56±0.14（P<0.01）。住院病死率溶栓组4例（5.5％）,PTCA组2（2.5％）无显著差异。1年期观察PTCA组治疗降低了心绞痛、再发心梗发生率和病死率。两组治疗比较差异有显著性。LVEF PTCA组0.58±0.18,溶栓组0.50±0.09,P<0.01。结论:直接PTCA支架治疗AMI与rtPA静脉溶栓相比具有较高的IRA再通率及良好的近期及1年期预后。Objective: To compare the clinical efficacy of primary percutaneous transluminal coronary angioplasty (PTCA) with thrombolytic therapy in acute myocardial infarction (AMI) . Methods: One hundred and fifty-six patients with AMI randomly underwent primary PTCA (84 patients) or intravenous rtPA (72 patients) .All patients were followed up for one year.Results: The recanalizing rates of IRA were 77% (56 cases) in thrombolytic therapy group and 100% (84 cases) in PTCA group (P<0.01). The treatment with PTCA decreased the complication of hemorrhage, angina pectoris, and reinfarction (P<0.05) .The reinfarction rates were 0.51± 0.18 in thrombolytic therapy group, and 0.56±0,14 in PTCA group(P<0.01) .The hospitalization dead rates were 5.5% (4 cases) in thrombolytic therapy group and 2.5% (2 cases) in PTCA group (P>0.05).The rates of reinfarction, angina pectoris,and hospitalization death significantly decreased with the treatment of PTCA by one-year follow-up. Conclusion: Primary PTCA provides the clinical advantage over thrombolytic therapy with rtPA in recanalizing rate of IRA, reducing recurrent ischemia, reinfarction, and preserving cardiac function after AMI.

关 键 词：rtPA静脉溶栓 直接PTCA冠脉支架术 治疗 急性心肌梗死 疗效观察 

分 类 号：R654.2[医药卫生—外科学]