不同治疗措施对急性心肌梗死疗效及卫生经济学评价

目的对比急性心肌梗死成功介入治疗及成功溶栓治疗的近、远期疗效和卫生经济学评价。方法纳入39例首发心肌梗死患者分别接受介入治疗或溶栓治疗,均治疗成功2周后观察心功能改变情况以评价近期疗效,随访1年评价远期疗效及卫生经济学评价。结果溶栓组患者近期疗效为90.90%、介入组为94.12%,两组比较差异无统计学意义(P>0.05)。随访1年,溶栓组无效率为36.36%、介入组为23.59%,介入组优于溶栓组(χ2=4.409,P<0.05)。溶栓组治疗后不良反应发生率为13.63%、介入治疗为11.77%,两组比较差异无统计学意义(P>0.05)。溶栓组最小治疗成本为(11729.2±5325.1)元、介入组为(49047.5±7632.2)元,溶栓组显著低于介入组(χ2=15.08,P<0.05)。两组治疗成本-效果分析结果显示,溶栓组较介入组降低明显,差异有统计学意义(χ2=11.29,P<0.05)。结论介入治疗与溶栓治疗近期疗效相当,虽远期疗效较好,但费用较高。患者应根据个人情况有选择地进行不同方法的治疗。

Effects and Health Economic Evaluation of Different Treatments of Acute Myocardial Infarction

Objective To evaluate the curative effect of the two successful intervention treatments of myocardial infarction in the acute and long-term stage.Methods 39 patients of first noset acute myocardial infarction were studied.There was no record of heart failure occurrence in the case history for all of them.We randomly assigned them to receive percutaneous coronary intervention or intravenous thrombolysis therapy,and all of them were treated 2 weeks after observation of the changes of heart function in evaluation of curative effect in the near future,followed for 1 year to evaluate the long-term efficacy and health economic evaluation.Results Intravenous thrombolysis therapy curative effect in the near future was 90.90%;and 94.12% in the intervention group,the difference between the two groups was not statistically significant(P>0.05).During the follow-up of 1 year,intravenous thrombolysis therapy without efficacy was 36.36%,the intervention group was 23.59%,the intervention group was better than that of thrombolytic therapy group(χ2=4.409,P<0.05).After treatment the incidence of adverse reactions in thrombolysis group was 13.63%,interventional treatment was 11.77%.There was no significant difference(P>0.05).Thrombolysis group minimum treatment cost analysis results for(11729.2±5325.1),the intervention group for(49047.5±7632.2),thrombolysis group was significantly lower than that of the intervention group(χ2=15.08,P<0.05).Cost effectiveness—effect analysis of the two groups indicated that thrombolysis group was obviously reduced compared with the intervention group,the difference was significant(χ2=11.29,P<0.05).Conclusion Interventional treatment has similar effect to thrombolytic therapy in the near future,although the long-term curative effect is better,the cost is high.Patients should choose different treatments based on individual circumstances.