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目的比较直接介入与易化介入治疗急性心肌梗死的疗效。方法连续入选急性心肌梗死患者132名,随机分为两组。易化介入组静脉注射普通肝素和重组组织型纤溶酶原激活剂；直接介入组静脉注射安慰剂。然后尽快行经皮冠脉介入治疗。观察30d全因死亡率、梗死相关血管再闭塞、术前与术后梗死血管开通率、左室射血分数和出血并发症。结果易化介入组与直接介入组30d死亡率、梗死相关血管再闭塞、左室射血分数、出血并发症差异无显著性(P＞0．05)。术前梗死血管开通率易化介入组高于直接介入组[39(59．1%)vs．16(24．2%),P＜0．05]；术后血管开通率两组相近[63(95．5%)vs．62 (93．9%),P＞0．05]。结论急性心肌梗死发病6h内采用易化介入与直接介入相比,30d死亡率、左心功能有改善趋势。而出血并发症未见增加,其预后可能优于直接介入治疗。
Objective To compare the efficacy of direct intervention and facilitation intervention in the treatment of acute myocardial infarction. Methods A total of 132 acute myocardial infarction patients were randomly divided into two groups. Yihua intervention group intravenous unfractionated heparin and recombinant tissue-type plasminogen activator; direct intervention group intravenous placebo. Then as soon as possible percutaneous coronary intervention. The 30-day all-cause mortality, infarct-related vascular reocclusion, preoperation and postoperative infarction vessel opening rate, left ventricular ejection fraction and bleeding complications were observed. Results The 30-day mortality, infarct-related vascular reocclusion, left ventricular ejection fraction, and bleeding complications in the intervention group and the intervention group were not significantly different (P> 0.05). The rate of preoperation infarction vessel opening was higher in intervention group than in direct intervention group [39 (59.1%) vs. 16 (24.2%), P <0.05]. The rates of postoperative vascular opening were similar in both groups [63 (95.5%) vs. 62 (93.9%), P> 0.05]. Conclusion Compared with the direct intervention, the incidence of 30-day mortality and left ventricular function have improved tendency within 6 hours after the onset of acute myocardial infarction. The bleeding complications did not increase, the prognosis may be better than direct interventional therapy.