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目的观察急性心肌梗死(AMI)溶栓后通心络干预治疗的效果。方法 2004年3月至2006年10月选择江西省抚州市第五医院符合诊断标准的急性心肌梗死(AMI)患者76例,随机分为 A 组(36例)和 B 组(40例)。A 组在常规治疗基础上先行尿激酶静脉溶栓,后用通心络干预治疗;B 组行常规治疗。观察6个月后的临床疗效。结果 A 组梗死相关血管(IRA)再通率(72.2%)明显高于 B 组(15%),2组差异有显著性意义(P<0.05);轻微出血并发症 A 组高于 B 组,但差异无显著性意义(P>0.05)。6个月后心电图运动试验阳性率、病死率、低密度脂蛋白胆固醇(LDL-C)水平 A 组明显低于 B 组(P<0.05);左室射血分数(LVEF)A 组明显高于 B组(P<0.05)。结论溶栓后通心络干预治疗 AMI 具有提高 IRA 再通率,改善心肌再灌注,防止心肌无再流现象,降低病死率等作用。
Objective To observe the effect of Tongxinluo intervention after acute myocardial infarction (AMI) thrombolysis. Methods From March 2004 to October 2006, 76 patients with acute myocardial infarction (AMI) who met the diagnostic criteria of the Fifth Hospital of Fuzhou City of Jiangxi Province were randomly divided into A group (36 cases) and B group (40 cases). Group A was given intravenous thrombolysis of urokinase on the basis of routine treatment, followed by intervention with Tongxinluo; group B was treated routinely. Observed after 6 months of clinical efficacy. Results The recanalization rate of infarction-related vessels (72.2%) in group A was significantly higher than that in group B (15%), and the difference was significant between two groups (P <0.05) But no significant difference (P> 0.05). After 6 months, the positive rate of electrocardiogram exercise test, mortality and LDL-C level in group A were significantly lower than those in group B (P <0.05); LVEF in group A was significantly higher than that in group B Group B (P <0.05). Conclusion The intervention of Tongxinluo after thrombolysis can improve the recanalization rate of IRA, improve myocardial reperfusion, prevent myocardial no-reflow and reduce mortality.