急性ST段抬高心肌梗死患者半量瑞替普酶溶栓后行易化经皮冠状动脉介入治疗的疗效评价  

Efficacy of facilitated PCI with half-dose reteplase for ST elevation myocardial infarction

作　　者：张守文[1] 王彩虹[2] 王洁[3] 潘金[1] 庄萍[1] 邵明凤[3] 张秋林 马波江 李新华[1] 

机构地区：[1]山东省临沂市人民医院心内科,山东临沂276003 [2]山东省临沂市人民医院药剂科,山东临沂276003 [3]山东省临沂市人民医院导管室,山东临沂276003 [4]河北省泊头市医院内二科 [5]陕西省榆林市第一医院心内科

出　　处：《中国介入心脏病学杂志》2015年第4期217-220,共4页Chinese Journal of Interventional Cardiology

基　　金：山东省临沂市2012年科学技术计划(201213033)

摘　　要：目的评价半量瑞替普酶溶栓后行易化经皮冠状动脉介入治疗(PCI)对急性ST段抬高心肌梗死(STEMI)患者的疗效和安全性。方法采用前瞻性、开放性的临床研究方法,观察2011年1月至2013年9月在山东省临沂市人民医院接受易化PCI和直接PCI的STEMI患者,分为易化PCI组(65例)和直接PCI组(70例),比较两组患者梗死相关血管(IRA)再通率、左心室射血分数(LVEF)、主要不良心血管事件(MACE,包括心原性死亡、再发心肌梗死、缺血复发、新发心力衰竭或心力衰竭恶化、出血等)发生率。结果易化PCI组再通率95.4%,直接PCI组再通率94.3%,两组患者冠状动脉再通率,术后30 d、3个月、6个月及12个月的LVEF比较,差异无统计学意义(P>0.05);术后30 d、3个月、6个月、12个月内MACE比较,差异无统计学意义(P>0.05)。结论应用半量瑞替普酶(r-PA)对STEMI患者行易化PCI是有效、安全的;在无直接PCI条件的医院,易化PCI是可行的。Objective Compared facilitated PCI with primary PCI in treatment of and study STEMI the effectiveness and safety of facilitated PCI with half-dose reteplase and primary PCI. Methods One hundred and thirty-five patients with STEMI admitted in our department from January 2011 to September 2013 were enrolled in the study. The patients received either facilitated PCI after successful thrombolysis with half-dose reteplase （ n = 65） or primary PCI （ n = 70） . The revascularization rates of IRA and MACE rates were compared between the 2 groups 30 days, 3 months, 6 months and 12 months after PCI. Results The successful revasculatization rates were 95.4% of IRA in the facilitated PCI group and 94. 3% in the primary PCI group （ P 〉 0. 05 ） . There were no statistical differences between the 2 groups in length of hospital stay, LVEF and MACE rates during follow up （all P 〉 0. 05） . Conclusions Facilitated PCI with half-dose reteplase for STEMI is effective and safe for hospitals not capable of primary PCI.

关 键 词：心肌梗死 瑞替普酶 溶栓治疗 经皮冠状动脉介入治疗 

分 类 号：R542.22[医药卫生—心血管疾病]