论文部分内容阅读
目的评价半量瑞替普酶溶栓后行易化经皮冠状动脉介入治疗(PCI)对急性ST段抬高心肌梗死(STEMI)患者的疗效和安全性。方法采用前瞻性、开放性的临床研究方法,观察2011年1月至2013年9月在山东省临沂市人民医院接受易化PCI和直接PCI的STEMI患者,分为易化PCI组(65例)和直接PCI组(70例),比较两组患者梗死相关血管(IRA)再通率、左心室射血分数(LVEF)、主要不良心血管事件(MACE,包括心原性死亡、再发心肌梗死、缺血复发、新发心力衰竭或心力衰竭恶化、出血等)发生率。结果易化PCI组再通率95.4%,直接PCI组再通率94.3%,两组患者冠状动脉再通率,术后30 d、3个月、6个月及12个月的LVEF比较,差异无统计学意义(P>0.05);术后30 d、3个月、6个月、12个月内MACE比较,差异无统计学意义(P>0.05)。结论应用半量瑞替普酶(r-PA)对STEMI患者行易化PCI是有效、安全的;在无直接PCI条件的医院,易化PCI是可行的。
Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization (PCI) for patients with acute ST-segment elevation myocardial infarction (STEMI) after thrombolysis with semi-quantitative temopeptide. Methods A prospective and open clinical study was conducted to observe the clinical efficacy of STEMI patients who underwent both PCI and PCI in Linyi People’s Hospital of Shandong Province from January 2011 to September 2013. The patients were divided into two groups: And the direct PCI group (70 cases). The recanalization rates of infarction-related blood vessels (IRA), left ventricular ejection fraction (LVEF), major adverse cardiovascular events (MACE), including cardiac death and recurrent myocardial infarction , Ischemia recurrence, new heart failure or worsening heart failure, bleeding, etc.). Results The rate of recanalization of PCI was 95.4% in the facilitated PCI group and 94.3% in the direct PCI group. The LVEF of coronary artery recanalization rate, 30 d, 3 months, 6 months and 12 months after operation in both groups were significantly different There was no significant difference between the two groups (P> 0.05). There was no significant difference in MACE at 30 d, 3 months, 6 months and 12 months after operation (P> 0.05). Conclusions The application of half-dose reteplase (r-PA) in the treatment of STEMI patients is effective and safe. In hospitals without direct PCI, it is feasible to facilitate PCI.