溶栓后时间优化PCI对急性心肌梗死患者远期预后的影响

目的:评价溶栓后时间优化PCI(percutaneous coronary intervention,PCI)对急性心肌梗死(acute myocardial infraction,AMI)患者远期预后的影响?方法:分析对比经溶栓后时间优化PCI或直接PCI(primary percutaneous coronary intervention,PPCI)治疗的132例ST段抬高型心肌梗死(ST elevation myocardial infraction,STEMI)患者的临床资料,包括治疗6个月内主要心脏不良事件(major adverse cardiac event,MACE)?左室射血分数(left ventricular ejection fraction,LVEF)和氨基末端脑利钠肽前体(N-terminal pro B-type natriuretic peptide,NT-Pro BNP),比较两种不同PCI策略对患者远期预后的影响?结果:两组患者除PCI术前冠脉造影心肌梗死溶栓(thrombolysis in myocardial infaction,TIMI)积分差异有统计学意义外,PCI治疗6个月后MACE事件发生率?LVEF及NT-Pro BNP水平均无统计学差异?结论:溶栓后时间优化PCI对STEMI患者远期预后的影响与PPCI相当,是无全天候PPCI能力医院抢救急性STEMI患者的一个可靠合适的替代方法?

The long-term prognostic value of optimal timely percutaneous coronary intervention after fibrinolysis for acute myocardial infraction

Objective:To evaluate the long-term strategically prognostic value of optimal timely percutaneous coronary intervention (PCI) after fibrinolysis in treatment of acute myocardial infraction (AMI). Methods:The study analyzed 132 patients,who were suffered with ST-elevation myocardial infraction (STEMI) and treated with different strategies either of optimal timely PCI after fibrinolysis or primary PCI,for the disparity of medical information,including the major adverse cardiac event (MACE),left ventricular ejection fraction (LVEF) and N-terminal pro b-type natriuretic peptide (NT-Pro BNP). Results:Beyond the TIMI angiographic flow before PCI,there were no significant difference in MACE,LVEF and NT-Pro BNP levels between the two groups of patients with different strategic therapies within a six-month period. Conclusion:Contrasted with primary PCI,the strategy of optimal timely PCI after fibrinolysis has equivalent impact on long-term prognosis of patients with STEMI. This strategy is also a reliable and feasible alternative for hospitals which are unable to delivery primary PCI service for STEMI patients promptly at an urgent time.