老年急性心肌梗死患者PCI与经静脉给药溶栓疗效的比较  

Comparison of therapeutic effect between PCI and intravenous administration thrombolysis on aged patients with acute myocardial infarction

作　　者：崔艳红 

机构地区：[1]山东省乐陵市人民医院心内科,山东乐陵253600

出　　处：《心血管康复医学杂志》2015年第6期653-656,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:比较经皮冠状动脉介入治疗(PCI)和经静脉给药溶栓两种方法治疗老年急性心肌梗死(AMI)患者的近远期临床疗效。方法:180例老年AMI患者分为PCI组和静脉溶栓组,各90例,比较两组患者的梗死相关血管的再通率,住院期间和随访期间左心室射血分数(LVEF)、主要心血管不良事件发生率。结果:与静脉溶栓组比较,PCI组患者的梗死血管再通率显著提高(61.1%比92.2%),在治疗结束时LVEF改善[(52.26±7.33)%比(58.27±7.59)%],和随访期间LVEF改善[随访3个月:(53.59±8.04)%比(60.44±7.53)%,随访12个月:(55.16±7.35)%比(63.71±7.77)%]更明显,且在随访12个月时,心脏不良事件的总发生率显著降低(82.22%比24.44%),P均<0.01。结论:经皮冠状动脉介入治疗急性心肌梗死梗死相关动脉的再通率,心功能恢复均显著好于静脉溶栓治疗,且心脏不良事件更少,可作为老年急性心肌梗死的首选治疗。Objective： To compare therapeutic effect of percutaneous coronary intervention （PCI） and intravenous administration thrombolysis on aged patients with acute myocardial infarction （AMI）. Methods： A total of 180 aged AMI patients were randomly and equally divided into PCI group and intravenous thrombolysis group （IVT group）. Recanalization rate of infarct-related artery （IRA）, left ventricular ejection fraction （LVEF） during hospitalization and follow-up, and incidence rate of major adverse cardiovascular events （MACE） were compared between two groups. Results： Compared with IVT group, there was significant rise in recanalization rate of IRA （61.1% vs. 92.2%）, significant improvement in LVEF at the end of treatment [（52.26 ± 7.33）% vs. （58.27 ± 7.59）%, and during follow-up [on three-month follow-up： （53.59 ± 8.04） % vs. （60.44± 7. 53） %, on 12-month follow-up： （55.16±7.35）% vs. （63.71± 7.77）%], and significant reduction in total incidence rate of MACE after 12-month follow-up （82.22% vs. 24.44%） in PCI group, P〈0.01 all. Conclusion： Compared with intravenous administration thrombolysis , the recanalization rate of infarct-related artery more high, cardiac function recovers more faster, MACE much less in PCI group, so PCI can be regarded as a preferred therapeutic plan for aged AMI

关 键 词：心肌梗死 血管成形术 气囊 冠状动脉 血栓溶解疗法 

分 类 号：R542.22[医药卫生—心血管疾病]