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目的对比分析12h内来院的急性心肌梗死(AMI)患者采用溶栓,直接冠脉成形术和转院后急诊冠脉成形术治疗方法对AMI患者预后的影响。方法将2004年1月-2005年12月来院的AMI12h内患者采取连续入组的方式分为溶栓治疗组(32例)和直接冠脉成形术治疗组(63例),以及外院转院于12h内行急诊冠脉成形术治疗组(25例),比较3组患者在院期间和出院后1年转归的差别。结果与直接冠脉成形术和转院后急诊冠脉成形术相比,溶栓组到院至再通时间间隔最短,分别平均为(1.1±0.2)h、(2.3±1.0)h和(2.1±1.1)h,(P<0.01),病死率(分别为6.3%、3.2%和4.0%)和1年后病死率(分别为12.5%、4.8%和8.0%)均未达统计学意义,溶栓组非致死性再梗死的发生率显著高于PCI组(分别为18.8%和4.5%,P<0.05)。结论AMI的救治关键是尽早开通罪犯血管,转院治疗也是较为安全有效的治疗方式。
Objective To compare the effects of thrombolysis, direct coronary angioplasty (PTCA) and post-hospital emergency coronary angioplasty (PTCA) on the prognosis of patients with acute myocardial infarction (AMI) within 12 hours after admission. Methods Patients were divided into thrombolytic group (32 cases) and direct coronary angioplasty group (63 cases) by AMI within 12 hours after hospital admission from January 2004 to December 2005, In the group of emergency coronary angioplasty (25 cases), the differences between the 3 groups in the hospital and 1 year after discharge were compared. Results Compared with direct coronary angioplasty and post-transurethral emergency coronary angioplasty, the time interval between the thrombolysis group and the hospital was the shortest, with an average of (1.1 ± 0.2) h, (2.3 ± 1.0) h and (2.1 ± 1.1% h, P <0.01). The case fatality rates (6.3%, 3.2% and 4.0%, respectively) and 1 year post mortem rates (12.5%, 4.8% and 8.0% The incidence of non-fatal restenosis in the suppository group was significantly higher than that in the PCI group (18.8% and 4.5%, respectively, P <0.05). Conclusion The key to the treatment of AMI is to open the criminals’ blood vessels as soon as possible. Transcation treatment is also a safe and effective treatment.