ST段抬高心肌梗死溶栓后早期冠脉介入治疗对心肌灌注的影响分析  

Effect Analysis of Early Coronary Intervention Therapy after Thrombolysis in ST Segment Elevation Myocardial Infarction for Myocardial Perfusion

作　　者：袁丹[1] 

机构地区：[1]辽宁省鞍山市台安县恩良医院心内科,辽宁鞍山114100

出　　处：《中外医疗》2016年第3期119-120,共2页China & Foreign Medical Treatment

摘　　要：目的通过比较溶栓后早期冠脉介入治疗与直接冠脉介入治疗对心肌灌注水平的影响,探讨ST段抬高心肌梗死(STEMI)患者溶栓后早期冠脉介入治疗的疗效。方法回顾性分析2013年1月—2015年1月入住该院的ST段抬高心肌梗死患者280例(男238例,女42例),经过冠脉造影检查(CAG)和介入治疗,根据患者之前是否接受静脉溶栓治疗将患者分为两组:早期PCI组和直接PCI组。其中,早期PCI组110例,采用早期冠脉介入治疗,直接PCI组170例,采用直接冠脉介入治疗。比较两组患者心肌灌注水平,采用TIMI心肌灌注分级(TMPG)进行评价。结果两组患者在冠脉造影检查与介入治疗结果中,早期PCI组TMPG2/3级的比例明显高于直接PCI组(76.4%vs.47.1%,P=0.032),差异有统计学意义(P<0.05)。结论溶栓后早期冠脉介入治疗与直接冠脉介入治疗相比,所获得的心肌灌注更好。Objective To discuss the curative effect of early coronary intervention therapy after thrombolysis in patients with ST segment elevation myocardial infarction by comparing the effects of early coronary intervention therapy and direct coronary intervention therapy after thrombolysis on myocardial perfusion level. Methods 280 cases（ male 238 cases, female 42cases） with ST segment elevation myocardial infarction treated in our hospital from January 2013 to January 2015 were retrospectively analyzed, and divided into early PCI group with 110 cases and direct PCI group with 170 cases according to whether the patient received venous thrombolysis therapy or not previously by coronary arteriography exanimation（CAG）and interventional therapy, the early PCI group were given early coronary intervention therapy, the direct PCI group were given direct coronary intervention therapy, the myocardial perfusion level of the two groups was compared and evaluated by TIMI myocardial perfusion grade（TMPG）. Results The results of coronary arteriography exanimation and interventional therapy showed that the proportion at TMPG2/3 grade in the early PCI group was obviously higher than that in the direct PCI group,（76.4% vs 47.1%,P=0.032）, and the difference was statistically significant（P〈0.05）. Conclusion After thrombolysis, the early coronary interventional therapy can get better myocardial perfusion compared with the direct coronary intervention therapy.

关 键 词：ST段抬高心肌梗死 早期冠脉介入治疗 直接冠脉介入治疗 心肌灌注 

分 类 号：R542.22[医药卫生—心血管疾病]