经皮冠状动脉支架置入术与尿激酶溶栓治疗急性心肌梗死临床疗效及安全性比较

摘要

目的:探讨经皮冠状动脉支架置入术与尿激酶溶栓治疗急性心肌梗死的临床疗效及安全性.方法:将急性心肌梗死患者50例随机分为两组各25例,支架组患者给予经皮冠状动脉支架置入术治疗,溶栓组患者则给予尿激酶溶栓,比较两组患者术后 TIMI血流分级、ST 段回落率总体情况、治疗前后相关心脏参数、住院期间与1年后随访相关心血管事件.结果:支架组患者术后T IM I血流分级与S T 段回落率总体情况均明显优于溶栓组(P<0.05);住院期间总体相关心血管事件发生率(12%)明显低于溶栓组(44%)(P<0.05);支架组患者治疗后LVESD(39.15 ± 2.27)与LVEDD水平(55.02 ± 2.20)比较均显著低于溶栓组[(45.01 ± 3.67)、(59.75 ± 2.38)](P<0. 05),L VEF水平(65.83 ± 3.54)比较显著高于溶栓组(56.32 ± 3.09)(P<0.05);治疗后1年随访总体心血管事件发生率(20%)统计学低于溶栓组(72%),存在显著性差异(P<0.01).结论:经皮冠状动脉支架置入术治疗急性心肌梗死的临床疗效较好,近期与远期安全性更高.%Objective:To investigate the clinical efficacy and safety of percutaneous coronary stenting and uro-kinase thrombolysis in the treatment of acute myocardial infarction.Methods:The incidence of TIMI blood flow and ST segment depression in the patients were significantly better than those in the thrombolysis group.The incidence of cardiovascular events(12%)was significantly lower than that of the thrombolysis group(44%)Differences(P<0.05).Results:The total incidence of cardiovascular events(12%)was significantly lower in thrombolysis group (44%)than that in thrombolysis group(44%),and the total incidence of cardiovascular events was significantly lower in patients with stent group(39.01 ± 2.27)and LVEDD(55.02 ± 2.20)were significantly lower than those in the thrombolysis group(45.01 ± 3.67,59.75 ± 2.38),and the difference was significant(P<0.05)(65.83 ± 3.54) was significantly higher than that in the thrombolysis group(56.32 ± 3.09).The incidence of cardiovascular events (20%)was significantly lower than that of the thrombolysis group(72%)at 1 year follow-up Differences(P<0. 01).The levels of LVESD(39.15 ± 2.27)and LVEDD(55.02 ± 2.20)were significantly lower in the stent group than those in the thrombolysis group(45.01 ± 3.67,59.75 ± 2.38)and LVEF(65.83 ± 3.54)(56.32 ± 3.09). The incidence of cardiovascular events(20%)was significantly lower than that of the thrombolysis group(72%), and there was significant difference(P<0.01).Conclusion:The clinical effect of percutaneous coronary stenting in the treatment of acute myocardial infarction is more remarkable,and the recent and long-term safety is higher.