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目的比较经皮冠状动脉介入(percutaneous coro nary intervention,PCI)和静脉溶栓治疗急性ST段抬高性心肌梗死(S T-segment elevation myocardia l infarction,STEMI)的临床疗效。方法 120例首发STEMI患者接受介入治疗和溶栓治疗并成功,其中60例行直接PCI治疗(PCI组),60例行静脉溶拴栓治疗(溶栓组),比较两组患者梗死后心绞痛发生率、左室收缩功能(左室射血分数)、平均住院天数、主要不良心血管事件发生率的差别。结果 PCI组梗死后心绞痛发生率低于溶栓组(0%VS32.4%,P<0.05),1个月时左室射血分数高于溶栓组[(56.48±5.79)%VS(49.76±5.41)%,P<0.05],平均住院天数少于溶栓组(7.84dVS10.40d,P<0.05),差异均有统计学意义。两者主要不良心血管事件差异无统计学意义。结论与静脉溶栓治疗相比,直接P CI能及时有效开通梗死相关动脉(infarct relatedartery,IRA),减少急性心肌梗死(acute myocardial infarction,AMI)患者梗死后心绞痛的发生率,改善患者的心功能,缩短住院天数,近期临床疗效优于静脉溶辁治疗。
Objective To compare the clinical effects of percutaneous coronary intervention (PCI) and intravenous thrombolysis in the treatment of acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 120 patients with initial STEMI underwent interventional therapy and thrombolysis and were successfully treated. Among them, 60 patients underwent direct PCI (PCI group) and 60 patients received intravenous infusion of thrombolytic therapy (thrombolytic group). Angina was compared between the two groups Rate, left ventricular systolic function (left ventricular ejection fraction), average length of stay, and incidence of major adverse cardiovascular events. Results The incidence of post-infarction angina pectoris in PCI group was lower than that in thrombolysis group (0% vs 32.4%, P <0.05). Left ventricular ejection fraction at 1 month was higher than that in thrombolysis group [(56.48 ± 5.79)% vs 49.76 ± 5.41 )%, P <0.05]. The average length of hospital stay was less than that of the thrombolytic group (7.84dVS10.40d, P <0.05). The differences were statistically significant. The difference between the two major adverse cardiovascular events was not statistically significant. Conclusions Compared with intravenous thrombolytic therapy, direct P CI can promptly and effectively open infarct related artery (IRA), reduce the incidence of post-infarction angina and improve cardiac function in patients with acute myocardial infarction (AMI) , Shorten the hospital stay, the recent clinical efficacy is superior to intravenous treatment.