急诊经皮冠状动脉腔内成形术与溶栓治疗急性心肌梗死的疗效比较

目的比较急诊经皮冠状动脉腔内成形术(PTCA)与溶栓治疗急性心肌梗死(AMI)的临床疗效.方法46例AMI患者,21例行急诊PTCA治疗,25例行溶栓治疗.结果急诊PTCA组梗死相关血管(IRA)成功开通的有20例,成功率为95%;溶栓组IRA再通有17例,成功率为68%,两组比较,P<0.01.出院前左心室射血分数(LVEF)急诊PTCA组为0.53±0.10,溶栓组为0.54±0.16,病死率分别为5%和4%,两组间差异无显著性(P>0.05).急诊PTCA组的平均费用明显比溶栓组高(P<0.05).结论急诊PTCA与溶栓治疗AMI患者,可使IRA充分有效地开通,故在条件允许的医院,可优先考虑行急诊PTCA治疗AMI.

Comparison of direct angioplasty and thrombolysis in acute myocardial infarction

Objective:To compare the efficacy of direct angioplasty with intravenous thrombolysis in the treatment of acute myocardial infarction (AMI). Methods:Forty six patients with AMI underwent either intravenous thrombolytic therapy (25 patients) or direct angioplasty (21 patients) were studied. Cardiac function (left ventricular ejection fraction,LVEF) was assessed during hospitalization by echocardiography. Results:The recanalizing rate of infarct related artery (IRA) was 68% in patients with thrombolytic therapy and 95% in those with direct angioplasty. There were no significant differences in age, risk factors, duration from onset of symptom and infarct location between the two groups. Conclusion: PTCA is more effective than intravenous thrombolysis in treatment of AMI since it is more likely to have successful IRA recanalization.