经皮冠状动脉支架置入术与尿激酶溶栓治疗急性心肌梗死临床疗效及安全性比较  

Comparison of clinical efficacy and safety of percutaneous coronary stent implantation and urokinase thrombolysis in the treatment of acute myocardial infarction

作　　者：刘杲 伊争伟 毛亚妮 Liu Gao;Yi Zhengwei;Mao Yani(Department of Cardiovascular Medicine,Xianyang Central Hospitalin,Shaanxi Province,Xianyang 712000)

机构地区：[1]陕西省咸阳市中心医院心血管内科,咸阳712000

出　　处：《陕西医学杂志》2018年第3期347-349,352,共4页Shaanxi Medical Journal

基　　金：陕西省卫生和计划生育委员会科研项目(2013JM40172)

摘　　要：目的:探讨经皮冠状动脉支架置入术与尿激酶溶栓治疗急性心肌梗死的临床疗效及安全性。方法:将急性心肌梗死患者50例随机分为两组各25例,支架组患者给予经皮冠状动脉支架置入术治疗,溶栓组患者则给予尿激酶溶栓,比较两组患者术后TIMI血流分级、ST段回落率总体情况、治疗前后相关心脏参数、住院期间与1年后随访相关心血管事件。结果:支架组患者术后TIMI血流分级与ST段回落率总体情况均明显优于溶栓组(P<0.05);住院期间总体相关心血管事件发生率(12%)明显低于溶栓组(44%)(P<0.05);支架组患者治疗后LVESD(39.15±2.27)与LVEDD水平(55.02±2.20)比较均显著低于溶栓组[(45.01±3.67)、(59.75±2.38)](P<0.05),LVEF水平(65.83±3.54)比较显著高于溶栓组(56.32±3.09)(P<0.05);治疗后1年随访总体心血管事件发生率(20%)统计学低于溶栓组(72%),存在显著性差异(P<0.01)。结论:经皮冠状动脉支架置入术治疗急性心肌梗死的临床疗效较好,近期与远期安全性更高。Objective:To investigate the clinical efficacy and safety of percutaneous coronary stenting and urokinase thrombolysis in the treatment of acute myocardial infarction.Methods:The incidence of TIMI blood flow and ST segment depression in the patients were significantly better than those in the thrombolysis group.The incidence of cardiovascular events(12%)was significantly lower than that of the thrombolysis group(44%)Differences(P<0.05).Results:The total incidence of cardiovascular events(12%)was significantly lower in thrombolysis group(44%)than that in thrombolysis group(44%),and the total incidence of cardiovascular events was significantly lower in patients with stent group(39.01±2.27)and LVEDD(55.02±2.20)were significantly lower than those in the thrombolysis group(45.01±3.67,59.75±2.38),and the difference was significant(P<0.05)(65.83±3.54)was significantly higher than that in the thrombolysis group(56.32±3.09).The incidence of cardiovascular events(20%)was significantly lower than that of the thrombolysis group(72%)at 1 year follow-up Differences(P<0.01).The levels of LVESD(39.15±2.27)and LVEDD(55.02±2.20)were significantly lower in the stent group than those in the thrombolysis group(45.01±3.67,59.75±2.38)and LVEF(65.83±3.54)(56.32±3.09).The incidence of cardiovascular events(20%)was significantly lower than that of the thrombolysis group(72%),and there was significant difference(P<0.01).Conclusion:The clinical effect of percutaneous coronary stenting in the treatment of acute myocardial infarction is more remarkable,and the recent and long-term safety is higher.

关 键 词：心肌梗塞/治疗 经皮冠状动脉介入治疗 支架 尿激酶型纤维蛋白酶原激活剂 血栓溶解疗法 

分 类 号：R542.2[医药卫生—心血管疾病]