摘要
目的 :探讨急性心肌梗死患者应用尿激酶联合经皮冠状动脉介入治疗 (PCI)的临床疗效。 方法 :96例首次急性心肌梗死患者随机分为静脉尿激酶溶栓联合PCI(A组 )和直接PCI (B组 )。A组 50例患者接受尿激酶 150万单位或 2 0 0万单位治疗后 ,行急诊冠状动脉造影 ,以心肌梗死溶栓治疗临床试验 (TIMI)血流分级法评估 ,必要时做PCI。B组 46例患者直接PCI。比较两组患者的梗死相关动脉开通率、并发症发生率、病死率、早期与最后心肌梗死面积 (2周后 )及左心室射血分数。 结果 :梗死相关动脉开通率A组为 94 0 % ,B组 95 7% ;两组患者首次造影时梗死相关动脉已达TIMI 3级血流者19例 (A组 13例 ,B组 6例 ) ,经PCI后变为TIMI 3级血流者 67例 (A组 3 3例 ,B组 3 4例 ) ;两组间术后 4周左心室射血分数无差异 ,均较治疗前显著改善 ,造影显示溶栓已达TIMI 3级血流者左心室射血分数明显好于直接PCI者 ;两组早期及最后心肌梗死面积无显著性差异 ;住院病死率A组 4 0 %、B组 2 7% ,均未见严重出血风险。 结论 :初步结果显示尿激酶溶栓联合PCI治疗急性心肌梗死 ,可使部分患者梗死相关动脉尽早开通 。
Objective: The aim of this study was to ob serve the clinical effect of urokinase (UK)plus percutaneous coronary i ntervention(PCI)in the treatment of acute myocardial in farction(AMI). Methods: Ninety six patients with first A MI were randomly treated with intraveno us UK thrombolysis therapy plus PCI (gr o up A,n=50)or with primary PCI (g roup B,n=46). Group A received UK 1 500 00 0 or 2 000 000 units.TIMI flow grade was assessed by emergent coronary angiography (CAG), and if necessary, by PCI. Pr imary PCI was performed in group B. The repe rfusion rate of infarction related a rtery(IRA), the occurrence rate o f complication,the mortality,the area of AM I,and left ventricular ejection fraction( LVEF)were compared between the two gr oups. Results: The reperfusion rate of IRA was 9 4 0% in group A and 95 7% in group B. IRA was in TIMI flow grade 3 in 19 patients(13 in group A and 6 in group B)on the first CAG. After PCI,TIMI 3 was achieved in 67(33 in group A and 34 in gro up B). Four weeks after PCI, LVEF had no difference between groups on echocardi ography, but both had more significant impr ovement than that before therapy. Th ere were no differences in the initial and f inal infarct size between groups.The mortality during hospitalization was 4 0% in group A and 2 7% in g roup B,and there was no serious hemorrhage in the two groups. Conclusion: The initial results showed th at UK plus PCI for AMI can make IRA pat ent as early as possible in some patients an d improve left ventricular function.
出处
《中国循环杂志》
CSCD
北大核心
2003年第5期340-342,共3页
Chinese Circulation Journal
