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目的：比较择期经皮冠脉成形术（ＰＴＣＡ），挽救ＰＴＣＡ，直接ＰＴＣＡ和药物治疗急性心肌梗死的效果。方法：比较三组治疗的死亡、再梗死和心绞痛的发生率，左室射血分数和左室舒张末内径。结果：１９９８年至１９９４年急性心肌梗死行冠状动脉造影共１００例，其中挽救ＰＴＣＡ１３例，择期ＰＴＣＡ２９例，直接ＰＴＣＡ１例，保守治疗５７例。与择期ＰＴＣＡ相比，挽救ＰＴＣＡ成功率低，残余狭窄重，左室射血分数低，死亡率、心绞痛和再梗死率高，但只有残余狭窄有显著差异。与保守治疗相比，择期ＰＴＣＡ残余狭窄轻，左室射血分数高，左室舒张末内径小，死亡和再梗死率低，直接ＰＴＣＡ１例，再通成功。结论：溶栓失败后可用ＰＴＣＡ补救，但远期效果不如择期ＰＴＣＡ，而且再通不成功死亡率较高，择期ＰＴＣＡ比较安全，效果优于保守治疗
Objective: To compare the effects of elective PTCM, salvage PTCA, direct PTCA and drugs on acute myocardial infarction. Methods: The incidence of death, reinfarction and angina pectoris, left ventricular ejection fraction and left ventricular end-diastolic diameter were compared between the three groups. Results: From 1998 to 1994, there were 100 cases of coronary angiography in acute myocardial infarction. Among them, 13 cases were rescuing PTCA, elective PTCA was in 29 cases, direct PTCA was in 1 case, conservative treatment was 57 cases. Compared with elective PTCA, saving PTCA success rate is low, residual stenosis, low left ventricular ejection fraction, mortality, angina and reinfarction rate, but only significant differences in residual stenosis. Compared with conservative treatment, elective PTCA residual stenosis, high left ventricular ejection fraction, small end-diastolic diameter, low rate of death and reinfarction, direct PTCA 1 cases, and then pass the success. Conclusion: PTCA can be used to remedy the failure of thrombolysis, but the long-term effect is not as good as that of elective PTCA, and the success rate of unsuccessful reinfusion is higher. Elective PTCA is safer and the effect is better than that of conservative treatment