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目的 :研究以溶栓或直接经皮冠状动脉腔内成形术 (PTCA)治疗年轻人急性心肌梗塞(AMT)的疗效。方法 :4 0岁以下AMT病人 50例分为溶栓治疗组 (30例 )和直接PTCA组 (2 0例 ) ,比较梗塞相关血管开通率和出院时左心室功能。结果 :尿激酶溶栓治疗组血流达TIMI 3级者 4 6 .2 % (14/ 30 ) ,且存在 80～ 95%的残余狭窄 ,出院时左心室射血分数 (LVEF)平均 4 5% ;直接PTCA治疗组术后血流全部达TIMI 3级 (10 0 % ) ,LVEF 6 0 % ,明显高于溶栓治疗组。结论 :年轻人AMI ,直接PTCA疗效明显高于溶栓治疗 ,值得推广。
Objective: To investigate the efficacy of thrombolysis or direct percutaneous transluminal coronary angioplasty (PTCA) in the treatment of young patients with acute myocardial infarction (AMT). Methods: Fifty patients with AMT under 40 years of age were divided into thrombolysis group (30 cases) and direct PTCA group (20 cases). The rates of infarction-related vascular opening and left ventricular function at discharge were compared. Results: The urokinase thrombolysis group had a TIMP level of 46.2% (14/30) and residual residual stenosis of 80-95%. The mean left ventricular ejection fraction (LVEF) at discharge was 45% ; The direct flow of blood after PTCA treatment group all reached TIMI 3 level (100%), LVEF 60%, significantly higher than the thrombolytic group. Conclusion: The efficacy of AMI and direct PTCA in young people is obviously higher than thrombolytic therapy, which is worthy of popularization.