急性前壁心肌梗死发病6h内溶栓与介入治疗疗效观察

目的：比较急性前壁心肌梗死发病6h内急诊溶栓与急诊经皮冠状动脉介入（percutaneous coronary intervention,PCI）治疗方法的临床疗效及预后。方法：选择首次发病6h内急性前壁心梗患者50例,其中采用r-tPA急诊溶栓24例,急诊PCI术26例,比较两组患者心电图ST段回落≥50%的时间,1个月内心血管事件的发生率,同时比较发病后1个月行超声心动图检查测量左室舒张末径及左室射血分数（LVEF）的数值。结果：两组患者心电图ST段回落≥50%的时间PCI组短于溶栓组,差异有统计学意义（P〈0.05）,心血管事件发生率再发心梗两组无统计学差异（P〉0.05）,猝死率PCI组优于溶栓组（P〈0.05）。1个月LVED及LVEF值PCI组明显优于溶栓组,差异有统计学意义（P〈0.01）。结论：急性前壁心梗6h内急诊行PCI术预后优于急诊溶栓,建议首选PCI术。

A Study on Clinical Efficacy in Anterior Wall Acute Myocardial Infarction in 6 Hours with Thrombolysis or PCI

Objective：To compare the efficacy with anterior wall acute myocardial treated by thromblysis or PCI. Methods： 50 patients with first anterior wall acute myocardial in 6 hours were selected, 24 patients with r-tPA acute thrombolysis,26 patients with acute PCI, The time of the resolution of ST segment elevation ≥50% was analyzed, adverse events were recorded and LVED, LVEF were recorded one months after treating. Results：The time of the resolution of ST segment in PCI group is shorter than the thromholysis group, having satistically significant. The remyocardial within one month were no satistically significant between two groups. The sudden death in PCI group were superor to thrombolysis group. LVED and LVEF in PCI group were significantly better than thrombolysis group in one month. Conclusion：The clinical outcome of acute anterior wall myocardial in 6 hours with PCI is superior to thrombolysis theraphy, so PCI is the first selection.