论文部分内容阅读
目的观察急性心肌梗死(AMI)合并糖尿病患者经尿激酶溶栓治疗后疗效以及溶栓后择期PCI术后的病变血管分析。旨在探讨急性心肌梗死患者有或无合并糖尿病早期静脉溶栓治疗的有效性、安全性和经PCI术后血管病变情况。方法 200例患者均有溶栓指征且无禁忌症,均给予同样的溶栓剂进行溶栓,病情稳定后择期经股动脉穿刺行PCI术。结果有和无糖尿病组的血管再通率分别为52.2%和74.7%(P<0.05);5周病死率分别为13.1%和4.8%(P<0.05);轻度出血等不良反应发生率分别为8.7%和6.8%(P<0.05);心脏射血分数EF值分别为53.44±11.1和62.9±10.2(P<0.05);有和无糖尿病组经PCI术病变血管分析分别为单支病变42.9%和45.2%(P>0.05);双支病变33.3%和34.1%(P>0.05);三支病变14.3%和12.6%(P>0.05);正常冠脉率分别为9.5%和8.1%(P>0.05)。结论 AMI合并糖尿病患者溶栓治疗,梗塞血管再通率明显低于无糖尿病患者,其近期预后也较后者差;经PCI术分析病变血管无明显差异。
Objective To observe the curative effect of thrombolytic therapy with urokinase in patients with acute myocardial infarction (AMI) complicated with diabetes mellitus and analyze the diseased vessels after elective PCI with thrombolysis. To investigate the efficacy and safety of early intravenous thrombolysis in patients with and without diabetes mellitus with acute myocardial infarction and the prevalence of vascular lesions after PCI. Methods 200 patients were indications of thrombolytic therapy and no contraindications, were given the same thrombolytic agent for thrombolysis, the condition was stable after elective femoral artery puncture underwent PCI. Results The rates of recanalization were 52.2% and 74.7% in those with or without diabetes mellitus (P <0.05). The 5-week mortality rates were 13.1% and 4.8% (P <0.05) respectively. The rates of mild adverse reactions such as mild bleeding were Were 8.7% and 6.8%, respectively (P <0.05). The EF values of cardiac ejection fraction were 53.44 ± 11.1 and 62.9 ± 10.2, respectively (P <0.05) % And 45.2%, respectively (P> 0.05). The incidences of double-vessel disease were 33.3% and 34.1% respectively (P> 0.05), three lesions were 14.3% and 12.6% P> 0.05). Conclusion Thrombolytic therapy in AMI patients with diabetes mellitus, infarction recanalization rate was significantly lower than non-diabetic patients, and its recent prognosis is worse than the latter; by PCI analysis of vascular lesions no significant difference.