尿激酶溶栓后即刻PCI与直接PCI治疗STEMI的比较

目的:比较溶栓后即刻经皮冠状动脉介入治疗(即刻PCI)与直接PCI治疗急性ST段抬高心肌梗死(STEMI)的安全性和疗效。方法:分析接受PCI治疗的连续130例STEMI患者冠脉病变及干预情况,随机分为尿激酶150万单位溶栓后即刻PCI和直接PCI两组,记录术中慢血流无血流、出血并发症、平均住院日、院内死亡率及平均18.1个月随访期间终点事件发生率。结果:两组临床特征及冠状动脉病变相似(P>0.05),即刻PCI组与直接PCI组相比,就诊-球囊时间、术中无血流慢血流、PCI成功率、出血并发症、平均住院日、院内死亡率以及18.1个月心血管事件发生事均无显著差异(P均>0.05)。结论:即刻PCI不增加出血并发症,但近期疗效和远期预后并未发现优于直接PCI。

Primary vs. Immediate Post-Urokinase Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

Objective:To evaluate whether immediate post-fibrinolysis percutaneous coronary intervention(PCI) repre- sents a reasonable reperfusion option for victims of ST-segment elevation myocardial infarction(STEMI).Methods:130 consec- utive STEMI patients(39 underwent immediate post-urokinase PCI,91 underwent primary PCI)were prospectively identified and followed up for a median of 18,1 months.Results:There was a similar clinical and coronary characteristic between two groups.Door-to-balloon time (120.50 vs 115.50 minutes,P>0.05),no-reflow (5.13% vs 8.79%,P>0.05),procedural success rate (97.44% vs 95.60%,P>0.05),bleeding complications(10.26% vs 8.79%,P>0.05),inhospital stays (9.50 vs 9.98 days,P>0.05) and cardiovascular events during hospitalization (2.56% vs 4.40%,P>0.05) and long-term follow-up(7.69% vs 10.99%,P>0.05) were also not significantly different between two groups.Conclusion:Despite its safety,immediate post-urokinase PCI seems not be superior to primary PCI in improving the prognosis of STEMI.