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目的 比较直接经皮冠状动脉腔内成形术（ 直接ＰＴＣＡ） 和静脉溶栓疗法在急性心肌梗死（ＡＭＩ） 治疗中的效果。方法 １２４ 例ＡＭＩ患者（ 直接ＰＴＣＡ组６０ 例，溶栓组６４ 例） 均于发病２ 周时和１２ 周后行９９Ｔｃｍ甲氧基异丁基异腈（ＭＩＢＩ）心肌断层显像，将左室心肌分为２０ 个节段，并对心肌摄取９９ＴｃｍＭＩＢＩ的程度进行打分，分别计算发病２ 周时心肌显像的总积分（Ｓ２ＷＳ） 、发病后１２ 周心肌显像的总积分（Ｓ１２ＷＳ）和两者相减的积分（ＳＤＳ）。直接ＰＴＣＡ组和溶栓组分别有３８ 人和３５ 人于心肌显像后行平衡法门控心室显像。结果 直接ＰＴＣＡ 组与溶栓组比较：Ｓ２ＷＳ为１８－３±６－９ 和２８－６ ±７－３（ｔ＝７－３，Ｐ＜ ０－００１），Ｓ１２ＷＳ为１１－２ ±４－２ 和２４－４ ±６－２（ｔ＝ １１－７，Ｐ＜ ０－００１），ＳＤＳ为７－６ ±３－２ 和４－３ ±１－１（ｔ＝ ５－４，Ｐ＜ ０－００１）。直接ＰＴＣＡ组和溶栓组入院２ 周时的左室射血分数（ＬＶＥＦ） 分别为（４１－４ ±６－５） ％ 和（３９－５ ±７－２）％ （ｔ＝ １－５ ，Ｐ＞ ０－０５），出院１２ 周后的ＬＶＥＦ 分别为（６２－６ ±７－８）％ 和（５１－４ ±
Objective To compare the effects of direct percutaneous transluminal coronary angioplasty (PTCA) and intravenous thrombolysis in the treatment of acute myocardial infarction (AMI). Methods 124 patients with AMI (direct PTCA group, 60 cases, 64 cases of thrombolytic group) were 99Tcm-methoxy-isobutyl isonitrile (MIBI) myocardial perfusion imaging at 2 weeks and 12 weeks after onset, the left ventricular myocardium was divided into 20 A segment of myocardial infarction and myocardial uptake of 99TcmMIBI level were scored were calculated at 2 weeks of onset of myocardial imaging total score (S2WS), 12 weeks after onset of myocardial imaging of the total score (S12WS) and both subtraction Integral (SDS). Thirty-five and thirty-five patients in the direct PTCA and thrombolytic groups, respectively, underwent myocardial perfusion imaging with a balance-gated ventricular imaging. Results Compared with the thrombolytic group, the direct PTCA group showed that the S2WS was 18-3 ± 6-9 and 28-6 ± 7-3 (t = 7-3, P <0-001) and the S12WS was 11-2 ± 4-2 And 24-4 ± 6-2 (t = 11-7, P <0-001), SDS was 7-6 ± 3-2 and 4-3 ± 1-1 (t = 5-4, 001). Left ventricular ejection fraction (LVEF) was (41-4 ± 6-5)% and (39-5 ± 7-2)%, respectively, at two weeks after admission in the direct PTCA group and the thrombolytic group (t = 1-5, P> 0-05), LVEF after 12 weeks of discharge were (62-6 ± 7-8)% and (51-4 ±