溶栓联合介入治疗老年急性心肌梗死22例报告

目的评价老人急性心肌梗死（AMI）静脉溶栓联合介入治疗（PCI）及直接介入（PCI）治疗的安全性及有效性。方法选取AMI患者22例，随机分为两组，A组先溶栓必要时行介入治疗14例，B组直接介入溶栓8例。分析其冠脉造影（CAG）介入前后梗死相关动脉（IRA）血流TMI分级、左心室功能（LVEF）及疗效。结果两组在梗死相关动脉（IRA）血流TMI分级、总开通率及血运重建等方面差异有显著意义（P〈0．01）。结论静脉溶栓提高IRA早期再通宰，迅速缓解临床症状，急诊介入治疗使IRA开通率高，但明显存在着再灌注时间延迟；老年人AMI联合治疗疗效安全有效。

Clinical analysis on treatment of senile acute myocardial infarction with thrombolysis combined with percutaneous coronary intervention

Objective To evaluate safety and effectiveness of treatment of senile acute myocardial infarction(AMI) with thrombolysis combined with percutaneous coronary intervention(PCI).Methods 22 patients suffering AMI were randomized into two groups.14 patients in group A were treated with thrombolysis,and they underwent PCI if necessary.8 patients in group B directly underwent thrombolysis combined with PCI.Parameters in coronary arteriography(CAG) including infarct-related artery(IRA),transient myocardial ischemia rating,left ventricule ejection fraction(LVEF) were analyzed.Results The two groups had significant difference(P<0.01) in IRA,TMI,total recanalization rate and blood-supply reconstruction.Conclusions Thrombolysis is able to help IRA get higher rate of early coronary recanalization,relieving symptoms immediately,while thrombolysis combined with PCI helps IRA get a higher rate of recanalization,but significantly delays re-perfusion time.Treating senile AMI with thrombolysis combined with PCI is safe and effective.