经皮冠状动脉成形术(PTCA)治疗急性心肌梗死合并心源性休克30例的疗效观察

目的观察急性心肌梗死合并心源性休克患者行急诊PTCA手术的疗效和其对心功能的影响。方法急性心肌梗死合并心源性休克患者68例,PTCA组30例,溶栓组38例。分析各组患者的临床特征,比较两组患者的住院时间、住院及随访期间不良心血管事件发生率、心功能恢复情况。观察PTCA组年龄、心梗病史、心肌灌注分级、高血压、糖尿病与死亡率的相关性。结果PTCA组较溶栓组血管开通率明显增高,PTCA组住院时间、不良心血管事件发生率、左室射血分数均好于溶栓组。PTCA组患者年龄、心梗病史、心肌灌注分级与死亡率呈正相关。结论PTCA治疗急性心肌梗死合并心源性休克患者是安全、有效的方法。年龄、心梗病史、心肌灌注分级是PTCA手术后患者死亡率的预测因素。

The efficacy of PTCA in the treatment of acute myocardial infaction complicated with cardiogenic shock

Objective:To observe the effect of percutaneous transluminal coronary angioplasty(PTCA)in patients with acute myocardial infaction complicated with cardiogenic shock.Methods: 30 patients were treated by PTCA,38 patients were treated by thrombolytic therapy,they were comparatively studied to observe clinical characteristics,length of hospital stay,major adverse cardiac events(MACE)and left ventricular ejection fraction(LEVT).The ralationship between age,history of myocardial infaction,myocardial blush grade and mortality were analyzed in PTCA group.Results: In PTCA group,the patency rate of infarction related artery(IRA)was significently improved.The length of hospital stay,major adverse cardiac events and LEVT were also better than thrombolytic group.The age,history of myocardial infarction,myocardial blush grade appeared postive correlation with mortality in PTCA group.Conclusions: PTCA can be a more safe and effective therapy in AMI companied with cardiogenic shock.Age,history of myocardial infarction,myocardial blush grade might be predictor of mortality in patients with cardiogenic shock follow PTCA.