心血管康复医学杂志
心血管康複醫學雜誌
심혈관강복의학잡지
Chinese Journal of Cardiovascular Rehabilitation Medicine
2015年
6期
653-655,656
,共4页
心肌梗死%血管成形术 ,气囊 ,冠状动脉%血栓溶解疗法
心肌梗死%血管成形術 ,氣囊 ,冠狀動脈%血栓溶解療法
심기경사%혈관성형술 ,기낭 ,관상동맥%혈전용해요법
Myocardial infarction%Angioplasty,balloon,coronary%Thrombolytic therapy
目的：比较经皮冠状动脉介入治疗（PCI）和经静脉给药溶栓两种方法治疗老年急性心肌梗死（AMI）患者的近远期临床疗效。方法：180例老年AMI患者分为PCI组和静脉溶栓组，各90例，比较两组患者的梗死相关血管的再通率，住院期间和随访期间左心室射血分数（LVEF）、主要心血管不良事件发生率。结果：与静脉溶栓组比较，PCI组患者的梗死血管再通率显著提高（61.1％比92.2％），在治疗结束时LVEF改善[（52.26±7.33）％比（58.27±7.59）％]，和随访期间LVEF改善[随访3个月：（53.59±8.04）％比（60.44±7.53）％，随访12个月：（55.16±7.35）％比（63.71±7.77）％]更明显，且在随访12个月时，心脏不良事件的总发生率显著降低（82.22％比24.44％）， P均＜0.01。结论：经皮冠状动脉介入治疗急性心肌梗死梗死相关动脉的再通率，心功能恢复均显著好于静脉溶栓治疗，且心脏不良事件更少，可作为老年急性心肌梗死的首选治疗。
目的：比較經皮冠狀動脈介入治療（PCI）和經靜脈給藥溶栓兩種方法治療老年急性心肌梗死（AMI）患者的近遠期臨床療效。方法：180例老年AMI患者分為PCI組和靜脈溶栓組，各90例，比較兩組患者的梗死相關血管的再通率，住院期間和隨訪期間左心室射血分數（LVEF）、主要心血管不良事件髮生率。結果：與靜脈溶栓組比較，PCI組患者的梗死血管再通率顯著提高（61.1％比92.2％），在治療結束時LVEF改善[（52.26±7.33）％比（58.27±7.59）％]，和隨訪期間LVEF改善[隨訪3箇月：（53.59±8.04）％比（60.44±7.53）％，隨訪12箇月：（55.16±7.35）％比（63.71±7.77）％]更明顯，且在隨訪12箇月時，心髒不良事件的總髮生率顯著降低（82.22％比24.44％）， P均＜0.01。結論：經皮冠狀動脈介入治療急性心肌梗死梗死相關動脈的再通率，心功能恢複均顯著好于靜脈溶栓治療，且心髒不良事件更少，可作為老年急性心肌梗死的首選治療。
목적：비교경피관상동맥개입치료（PCI）화경정맥급약용전량충방법치료노년급성심기경사（AMI）환자적근원기림상료효。방법：180례노년AMI환자분위PCI조화정맥용전조，각90례，비교량조환자적경사상관혈관적재통솔，주원기간화수방기간좌심실사혈분수（LVEF）、주요심혈관불량사건발생솔。결과：여정맥용전조비교，PCI조환자적경사혈관재통솔현저제고（61.1％비92.2％），재치료결속시LVEF개선[（52.26±7.33）％비（58.27±7.59）％]，화수방기간LVEF개선[수방3개월：（53.59±8.04）％비（60.44±7.53）％，수방12개월：（55.16±7.35）％비（63.71±7.77）％]경명현，차재수방12개월시，심장불량사건적총발생솔현저강저（82.22％비24.44％）， P균＜0.01。결론：경피관상동맥개입치료급성심기경사경사상관동맥적재통솔，심공능회복균현저호우정맥용전치료，차심장불량사건경소，가작위노년급성심기경사적수선치료。
Objective:To compare therapeutic effect of percutaneous coronary intervention (PCI ) and intravenous administration thrombolysis on aged patients with acute myocardial infarction (AMI) .Methods :A total of 180 aged AMI patients were randomly and equally divided into PCI group and intravenous thrombolysis group (IVT group) . Recanalization rate of infarct‐related artery (IRA) ,left ventricular ejection fraction (LVEF) during hospitalization and follow‐up ,and incidence rate of major adverse cardiovascular events (MACE ) were compared between two groups .Results:Compared with IVT group ,there was significant rise in recanalization rate of IRA (61.1% vs . 92.2% ) ,significant improvement in LVEF at the end of treatment [ (52.26 ± 7.33)% vs . (58.27 ± 7.59)% ,and during follow‐up [on three‐month follow‐up: (53.59 ± 8.04)% vs . (60.44 ± 7.53)% ,on 12‐month follow‐up:(55.16 ± 7.35)% vs .(63.71 ± 7.77)% ] ,and significant reduction in total incidence rate of MACE after 12‐month follow‐up (82.22% vs .24.44% ) in PCI group ,P<0.01 all .Conclusion:Compared with intravenous administration thrombolysis ,the recanalization rate of infarct‐related artery more high ,cardiac function recovers more faster , MACE much less in PCI group ,so PCI can be regarded as a preferred therapeutic plan for aged AMI .
