小剂量溶栓药静脉溶栓及补救性介入治疗对ST段抬高性心肌梗死患者的疗效及安全性研究被引量：4

Study on the safety and efficacy of rescue angioplasty following low-dose thrombolytic therapy in acute myocardial infarction

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摘要目的:探讨小剂量溶栓药静脉溶栓及补救介入性治疗ST段抬高性心肌梗死(STelevatedmyocardialinfarction,STEMI)患者的安全性及疗效。方法:104例STEMI患者,按入组顺序并征得患者知情同意后分为两组,62例接受直接经皮冠状动脉介入治疗(percutaneouscoronaryintervention,PCI,指冠状动脉成形术)为PCI组,另42例为溶栓后补救性PCI组,先行小剂量组织型纤维蛋白溶酶原激活剂静脉溶栓,随后行冠状动脉造影,心肌梗死溶栓试验低于2级血流者行补救性PCI。比较两组的梗死相关动脉(infarctrelatedartery,IRA)开通率、左心室射血分数、ST段回落率、主要不良心脏事件。结果:与直接PCI组比较,溶栓后补救性PCI组具有较高的左心室射血分数(0.56±0.08比0.61±0.10,P<0.01)和ST段回落率(81%比95%,P<0.05),IRA开通率和主要不良心脏事件两组比较差异无统计学意义(均为P>0.05)。溶栓后补救性PCI组出血发生率无增加。结论:小剂量溶栓药静脉溶栓及补救性介入治疗是ST段抬高性AMI获得早期持续再灌注安全而有效的方法。 Objective： To study the safety and efficacy of rescue angioplasty following low-dose thrombolytic therapy in acute myocardial infarction（AMI）. Methods： Sixty-two patients with ST elevated myocardial infarction （STEMI） were treated with direct percutaneous coronary intervention （PCI）, and 42 patients with STEMT were treated with rescue angioplasty following low-dose thrombolytic therapy. The left ventricular ejection fraction （LVEF）, ST-segment decline rate, reperfusion rate and major adverse cardiac event （MACE） rate were compared between the two groups. Results： The LVEF and ST-segment decline rate in the rescue angioplasty group were significantly higher than those in PCI group （0. 56 ±0. 08 vs 0. 61 ±0. 10, P 〈0. 01, 81% vs 95%, P 〈0. 05）. The reperfusion rate and MACE rate had no differences between the two groups （P 〉 0. 05）. No serious bleeding occurred in the rescue angioplasty group. Conclusion： The rescue angioplasty following low-dose thrombolytic therapy is safe and efficient.

作者吕瑞娟张运陈玉国王文君

机构地区山东大学齐鲁医院急诊科山东大学齐鲁医院心内科

出处《新医学》北大核心 2005年第11期639-641,共3页 Journal of New Medicine

关键词心肌梗死血管成形术经皮冠状动脉介入治疗溶栓治疗直接经皮冠状动脉介入治疗补救性PCI 心肌梗死患者安全性研究 ST段抬高静脉溶栓 Myocardial iniarction Angioplasty Percutaneous coronary intervention Thrombolytic therapy

分类号 R542.22 [医药卫生—心血管疾病] R473.5 [医药卫生—护理学]

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