论文部分内容阅读
目的：旨在观察ＰＴＣＡ＋ 支架对急性前壁心肌梗塞溶栓失败病例的影响。方法：１２８例急性前壁心肌梗塞溶栓失败病例根据是否接受过ＰＴＣＡ＋ 支架治疗分为两组。Ａ组６８ 例心肌梗塞后接受ＰＴＣＡ＋ 支架＋ 药物治疗。Ｂ组６０ 例常规药物治疗，观察６ 个月、１２ 个月时的心绞痛发生率，再梗率，ＥＦ值及死亡率。结果：Ａ组６８ 例心肌梗塞后６个月时心绞痛发生率１８％ ，再梗率１．５％ ，死亡率１．５％ ，ＥＦ值５２％ ±１０％ ，Ｂ组心肌梗塞后６ 个月时心绞痛发生率２５％ ，再梗率４．５％ ，死亡率５．０％ ，ＥＦ值４６％ ±１２％ 。心肌梗塞后１２ 个月时Ａ组心绞痛发生率２８．７％ ，再梗率４．５％ ，ＥＦ值５５％ ±９％ ，死亡率４．５％ ，Ｂ组分别为３５％ ，１２％ ，１０％ ，５４％ ±１０％ 。结论：ＰＴＣＡ＋ 支架可减低心肌梗塞患者短期和远期的再梗率以及心绞痛发病率，但和药物治疗相比，不降低长期的死亡率，亦不能明显增加射血分数，改善心功能。
Objective: To investigate the impact of PTCA + stent on the cases of failed anterior thrombolytic therapy of anterior myocardial infarction. Methods: A total of 128 patients with acute anterior myocardial infarction who underwent thrombolysis were divided into two groups based on whether PTCA + stent was treated or not. A group of 68 patients received myocardial infarction PTCA + stent + drug treatment. Group B, 60 cases of conventional drug treatment, observation of 6 months, 12 months of angina pectoris, reperfusion rate, EF and mortality. Results: The incidence of angina pectoris was 18%, the rate of re-infarction was 1.5%, the mortality rate was 1.5% and the EF was 52% ± 10% at 6 months after MI in group A, 6 months after myocardial infarction in group B The incidence of angina was 25%, the rate of reinfarction was 4.5%, the mortality rate was 5.0% and the EF was 46% ± 12%. The incidence of angina pectoris was 28.7%, the rate of re-infarction was 4.5%, the EF was 55% ± 9% and the mortality rate was 4.5% at 12 months after myocardial infarction. The rate of angina pectoris in group B was 35%, 12% 10%, 54% ± 10%. Conclusion: PTCA + stent can reduce short-term and long-term restenosis rate and angina pectoris in patients with myocardial infarction. However, compared with drug treatment, PTCA + stent can not significantly reduce long-term mortality, and can not significantly increase ejection fraction and improve cardiac function.