急性心肌梗死急诊介入治疗与静脉溶栓后急诊介入治疗的比较研究  

Comparison of emergency percutaneous coronary intervention and intravenous thrombolysis with urokinase combined with emergency percutaneous coronary intervention for acute myocardial infarction

作　　者：韩立宪[1] 王贵松[1] 徐泽升[1] 高巍[1] 张军[1] 马增才[1] 彭万忠[1] 崔海英[1] 李洪稳[1] 周继新[1] 王玉刚[1] 尚爱英[1] 元柏民[1] 

机构地区：[1]河北省沧州市中心医院心内科,061001

出　　处：《中国介入心脏病学杂志》2002年第4期209-210,共2页Chinese Journal of Interventional Cardiology

摘　　要：目的　探讨联合应用尿激酶静脉溶栓与急诊介入疗法治疗急性心肌梗死 (AMI)的有效性和安全性。方法　 5 2例发病≤ 12h的首次AMI患者随机分为溶栓 +经皮冠状动脉介入治疗 (PCI)组 (2 6例 )和直接PCI组 (2 6例 ) ,对两组患者介入治疗前梗死相关血管 (IRA)通畅率、介入治疗成功率、出血并发症发生率、住院期间急性缺血事件发生率及出院前左心室功能 (LVEF)进行比较。结果　介入治疗前溶栓 +PCI组IRA通畅率 (6 1 5 %)显著高于直接PCI组 (19 2 %) (P <0 0 5 ) ,两组介入治疗成功率均为 10 0 %,其中TIMIⅢ级血流者分别为 96 2 %和 91 5 %(P >0 0 5 ) ;住院期间两组均无严重出血及急性缺血事件发生 ,出院前经超声心动图测得LVEF在溶栓 +PCI组为 (6 4 3± 5 6 ) %,明显高于直接PCI组 (5 4 8± 4 9) %(P <0 0 1)。结论　尿激酶静脉溶栓联合急诊介入疗法治疗AMI早期再通率高 ,更有利于保护左室功能 ,不增加出血并发症。Objective To evaluate the efficacy and safety of intravenous thrombolysis with urokinase combined with emergency interventional therapy for acute myocardial infarction(AMI). Methods Fifty two patients with first AMI (≤12 h from onset)were randomized to thrombolysis plus PCI group and primary PCI group,the patency rate of infarct related artery (IRA) before intervention,the procedural success rate,the incidence of bleeding complications and acute ischemic events during hospitalization and the left ventricular ejection fraction (LVEF) measured by echocardiography before discharge were compared.Results The IRA patency rate in the thrombolysis plus PCI group (61 5%) was significantly higher than that in the primary PCI group (19 2%) ( P <0 05),the procedural success rate was 100% with TIMI Ⅲ flow of 92 2% and 91 5% in the two groups ( P >0 05),no major bleeding complication and acute ischemic event occurred during hospitalization in both groups,the LVEF in the thrombolysis plus PCI group (64 3±5 6)% was higher than that in the primary PCI group(54 8±4 9)% before discharge ( P <0 05).Conclusion Intravenous thrombolysis with urokinase combined with emergency interventional therapy for AMI was safe and effective with a higher early patency rate,better cardiac function and no major bleeding complications.

关 键 词：急性心肌梗死 静脉溶栓 尿激酶 经皮冠状动脉介入治疗 AMI 

分 类 号：R542.220.5[医药卫生—心血管疾病]