摘要
目的 评价直接经皮冠状动脉介入治疗 (PCI)与溶栓治疗急性心肌梗死合并糖尿病患者的近期与远期临床疗效。方法 采用回顾性分析合并糖尿病的急性心肌梗死患者 5 4例 ,发病时间均在 6小时以内。 2 1例给予溶栓治疗 (溶栓治疗组 ) ,33例接受直接PCI治疗 (直接PCI组 )。比较两组患者 1年内心脏事件发生率。结果 除去在直接PCI组Killip≥Ⅲ级患者较多外 (2 7.2 %vs4 .7% ,P =0 .0 38) ,两组间基本临床资料相似。直接PCI组术后住院期间心肌缺血发生率 (3.0 %vs 2 3.8% ,P =0 .0 18)及 1年内靶血管的再次血管成形术率 (9.0 %vs 33.3% ,P =0 .0 2 5 )均明显低于溶栓治疗组。死亡及再梗死率亦低于溶栓治疗组 (6 .0 %vs 2 8.4 % ,P =0 .0 2 3)。出血率 (9.0 %vs9.0 % ,P =0 .95 7)及脑卒中发生率 (3.0 % vs0 .0 % ,P =0 .4 2 1)两者相比差异无统计学意义。
Objective To compare the early and late outcome of primary percutaneous coronary interventions(PCI)with fibrinolytic treatment among diabetic patients with acute myocardial infarction (AMI).Methods 54 consecutive diabetic patients with AMI receiving reperfusion treatment within six hours of symptom onset.Fibrinolytic treatment was administered to 21 patients,and 33 patients underwent primary PCI.All patients received adjunctive stenting.Assess the Main clinical Events after PCI during one year.Results Baseline characteristics were similar in these two treatment groups.except that the proportion of patients with Killip≥Ⅲ class was considerably higher in those treated with primary PCI( 27.2% vs 4.7%,P= 0.038).Among those treated with PCI,the rates for in-hospital recurrent ischaemia( 3.0% vs 23.8%,P= 0.018) and target vessel revascularisation( 9.0% vs 33.3%,P= 0.025)were lower.Death or reinfarction at one year( 6.0% vs 28.4%,P= 0.023)was also reduced among those treated with PCI.There was not significant difference of the rates of stroke( 3.0% vs 0.0%,P= 0.421) and bleeding( 9.0% vs 9.0%,P= 0.957)between the two groups.Conclusion Among diabetic patients with AMI,primary PCI was associated with reduced early and late adverse events compared with fibrinolytic treatment.
出处
《临床荟萃》
CAS
北大核心
2004年第3期138-140,共3页
Clinical Focus
关键词
心肌梗塞
糖尿病
血管成形术
经腔
经皮冠状动脉
血栓溶解疗法
acute myocardial infarction
Diabetes mellitus
angioplasty,transluminal,percutaneous coronary
thrombolytic therapy
