静脉溶栓合并急诊介入治疗急性心肌梗死的疗效

目的：探讨急性心肌梗死（AMI）静脉溶栓后急诊介入治疗的疗效。方法：选择我院2011年3月到2012年8月收治的128例AMI患者，系发病12h内且无溶栓禁忌证的初发患者，随机均分成两组：溶栓＋PCI组[系静脉溶栓后进行急诊介入治疗（PCI）]；直接PCI组（未经溶栓直接进行PCI）。比较两组患者心肌梗死相关动脉（IRA）开通率，治疗效果，及并发症的发生率。结果：术前到达导管室时IRA已达TIMI3级血流者共32例，其中静脉溶栓后进行急诊介入治疗组24例（37．5％）显著高于直接PCI组的8例（12．5％），P〈0．05。术后溶栓＋PCI组IRA达TIMI3级血流者明显多于直接PCI组（75．0％比50％），住院期间两组均无严重出血并发症发生。结论：静脉溶栓联合介入疗法治疗急性心肌梗死梗死相关动脉再通率高，更有利于保护左心室功能，并降低心脏事件的发生。

Therapeutic effect of intravenous thrombolysis combined emergency percutaneous coronary intervention on acute myocardial infarction

Objective： To explore therapeutic effect of intravenous thrombolysis combined emergency percutaneous coronary intervention （PCI） on acute myocardial infarction （AMI）. Methods： A total of 128 AMI patients, who were primary attack within 12h and admitted in our hospital from Mar 2011 to Aug 2012 without contraindications for thrombolysis, were selected and randomly and equally divided into thrombolysis ＋ PCI group （received emer- gency PCI after intravenous thrombolysis） and direct PCI group. Open rate of infarct related artery （IRA）, thera- peutic effect and incidence rates of complications were compared between two groups. Results： When arrived at catheter room before PCI, infarct related artery （IRA） had reached thrombolysis in myocardial infarction （TIMI） flow grade 3 in 32 cases, there were 24 cases （37.5%） in thrombolysis ＋ PCI group, which were significantly more than the eight cases （12.5%） in direct PCI group, P〈0.05. After PCI, percentage of patients whose IRA reached TIMI flow grade 3 was 75% （48/64） in thrombolysis ＋ PCI group, which was significantly higher than that of di-rect PCI group E50% （32/64）1. No severe bleeding complication occurred in both groups during admission. Conclu-sion： Intravenous thrombolysis combined interventional treatment possesses high open rate of infarct related artery, is more helpful in protecting left ventricular function and decreases incidence of cardiac events in early acute myo- cardial infarction.