论文部分内容阅读
目的观察延迟冠状动脉(冠脉)介入治疗(PCI)对急性心肌梗死患者远期疗效的影响。方法回顾性分析1996年1月至2002年10月我院276例急性心肌梗死患者的临床资料,根据患者是否接受介入治疗或接受介入治疗的种类、将患者分为直接急诊PCI治疗组(急诊组)75例,延迟PCI治疗组(延迟组)73例以及常规药物治疗组(对照组)128例。收集并分析住院期间的临床资料,对存活出院的患者随访,记录主要心血管事件(MACE)的发生情况,并于出院第12~48个月进行超声心动图检查。结果基线资料急诊组ST段抬高例数高于其他两组,住院天数明显降低(P<0.05)。住院期间病死率对照组明显高于急诊组和延迟组。平均随访4.3±2.7年(1.8~7.5年),完成随访247人(89.5%)。随访期左心室射血分数(LVEF)值延迟组为57.4%±3.4%,急诊组为59.3%±7.5%,对照组为54.7%±4.1%。延迟组死亡1例,急诊组死亡1例,对照组死亡14例。与对照组相比,延迟PCI治疗可改善心肌梗死患者的左心室功能,降低远期MACE的发生率;与急诊组相比,其左心室功能改善及远期临床事件发生率的降低差异无统计学意义。结论与常规药物治疗相比,延迟PCI治疗可改善急性心肌梗死患者的远期预后。
Objective To observe the effect of delayed coronary intervention (PCI) on the long-term outcome of patients with acute myocardial infarction. Methods The clinical data of 276 patients with acute myocardial infarction in our hospital from January 1996 to October 2002 were retrospectively analyzed. Patients were divided into direct emergency PCI group (emergency group) according to whether they received interventional therapy or received interventional therapy ), 75 cases of delayed PCI (delayed group), 73 cases of conventional drug treatment group (control group), 128 cases. Clinical data were collected and analyzed during follow-up period. Survival patients discharged were followed up and MACE events were recorded. Echocardiography was performed 12 to 48 months after discharge. Results The number of ST segment elevation in the emergency department was significantly higher than that in the other two groups (P <0.05). Mortality during hospitalization was significantly higher in the control group than in the emergency group and in the delayed group. The average follow-up was 4.3 ± 2.7 years (1.8-8.5 years), followed by 247 (89.5%) follow-up visits. The left ventricular ejection fraction (LVEF) in the follow-up group was 57.4% ± 3.4% in the delayed group, 59.3% ± 7.5% in the emergency group and 54.7% ± 4.1% in the control group. 1 patient died in delay group, 1 patient died in emergency group and 14 patients died in control group. Compared with the control group, delayed PCI could improve left ventricular function and reduce the incidence of long-term MACE in patients with myocardial infarction. Compared with the emergency group, no significant difference was found in the improvement of left ventricular function and the incidence of long-term clinical events Significance of learning. Conclusions Delayed PCI improves long-term prognosis in patients with acute myocardial infarction compared with conventional medical therapy.