老年急性心肌梗死直接介入治疗与溶栓治疗临床效果评价(1)
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【摘要】 目的评价急诊冠状动脉介入治疗(PCI)与静脉溶栓治疗对老年急性心肌梗死(AMI)患者的近期临床疗效。方法65例60岁以上的ST段抬高的(AMI)老年患者,31例接受急诊PCI治疗,34例接受静脉溶栓治疗,比较两种治疗方法对患者的临床近期效果。结果 溶栓组梗塞相关血管(IRA)再通率为58.8%,急诊PCI组IRA再通率为96.8%;6个月时左室射血分数(LVEF)溶栓组为40.2%±6.3%,急诊PCI组为53.8%±6.7%,差异有显著性(P<0.05);出血并发症、住院期间病死率、再发心绞痛和主要心脏事件发生率,溶栓组比率明显高于急诊PCI组(44.1%:9.7,P<0.05)。溶栓组平均住院天数为8.5d,PCI组平均住院天数为18.5d,两组间差异有显著性(P<0.05)。结论对老年急性心肌梗死患者,急诊冠状动脉介入治疗更能尽快、及时有效地开通梗死相关动脉,挽救濒死心肌,改善左室功能,降低病死率。
【关键词】急性心肌梗死;经皮冠状动脉腔内成形术;血栓溶解疗法
中图分类号:R542.22文献标识码:A文章编号:1005-0515(2010)02-017-02
Clinical Efficacy Evaluation of Direct Percutaneous Coronary Intervention and Thrombolytic Therapy in Aged Patients with AMI
Wu Baosheng
Tanghai County Hospital in Hebei Province063200
【Abstract】 ObjectiveTo evaluate the clinical efficacy of direct percutaneous coronary intervention (PCI) and thrombolytic therapy aged patients with acute myocardial infarction (AMI)。Methods Sixty-five aged patients (age≥60years old) with AMI were divided into direct PCI treatment group (n=31) and thrombolytic therapy group (n=34)。The clinical outcomes between the two group were compared。Results The infarct-related artery (IRA) reperfusion rate in the patients with intravenous thrombolysis was 58.8%;While in the PCI group the IRA reperfusion rate was 96.8%。There was significant differences in left ventricular ejection farction (LVEF) in six months after AMI between thrombolytic group and the PCI geroup (40.2%±6.3%vs53.8%±6.7%,P<0.05) 。The ratio was higher in thrombolytic group than in PCI group among complicated hemorrhage rate。The average days staying inhospital was less in the PCI group than in the thrombolytic group。Conclusion Direct emergency PCI in elder oatuebts with AMI could rapidly and efficaciously reperfuse IRA ,rescue dying myocardium, improve left ventricular function, and reduce the mortality of AMI in the aged patients。
【Key words】Acute myocardial infarction Percutaneoustransluminal coronary intervention Thrombolytic theapy
老年急性心肌梗死由于病情相对复杂,表现严重,并发症多,因此其治疗的关键在于及时使梗死相关冠状动脉再通,迅速恢复再灌注,挽救濒死的心肌,对年龄≥60岁的老年AMI患者依据临床不同情况,观察直接PTCA及支架术与溶栓两组患者的治疗效果 ......
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