急性心肌梗死直接PCI与溶栓后补救性PCI的对比研究

目的:研究急性心肌梗死后直接经皮冠脉介入治疗(PCI)和溶栓后补救性PCI的临床造影结果和短期预后,观察终点为30天的死亡率。 方法:连续入选150例ST段抬高的急性心肌梗死患者。按溶栓与否分为直接PCI组110例(73.3％)和溶栓后补救性PCI组40例(26.7％),溶栓药物包括重组葡激酶、重组组织型纤溶酶原激活剂、重组纤溶酶原激活剂和尿激酶。分析其临床、造影和预后特点。 结果:与溶栓后补救性PCI组比较,直接PCI组CK和CK-MB峰值低(P<0.05),校正的心肌梗死溶栓临床试验的帧数(corrected TIMI framecounts,CTFC)低(P<0.05),心肌梗死溶栓临床试验心肌灌注分级(TIMI myocardial perfu-sion grades,TMPG)高(P<0.05),死亡率显著降低(P<0.01)。 结论:溶栓后补救性PCI可能使心肌酶增高,死亡率增加。

The study of comparing primary-PCI and rescue-PCI after thrombolysis in acute myocardial infarction

Objective:To study the clinical and angiographic characteristics and the short-term outcome of primary-PCI and rescue-PCI after thrombolysis in acute myocardial infarction. Methods: A total of 150 consecutive acute myocardial infarction patients with ST segment elevation were divided into two groups : primary-PCI group(n= 110) or rescue-PCI group(n = 40). The drugs for thrombolysis included r-SAK,rt-PA,r-PA and UK. The clinical, angiographic and prognostic features were analyzed. Results: Compared to rescue-PCI group,the peak values of CK, CK-MB were low(P<0. 05) ,CTFC(corrected TIMI frame counts)was low(P< 0. 05) ,TMPG(TIMI myocardial perfusion grades)was high(P<0. 05) and mortality rate was significantly de-creased(P<0. 01) in primary-PCI group. Conclusions: Rescue-PCI could increase mortality rate and the value of cardiac enzymes.