急诊冠状动脉介入治疗急性心肌梗死的临床研究

目的对急性心肌梗死（AMI）急诊冠状动脉介入（PCI）的疗效进行评价。方法1999年12月至2004年12月，我们对207例AMI患者进行了急诊PTCA＋stent治疗，对其疗效与静脉溶栓治疗进行了对比，195例进行了院外随访。结果IRA再通率97．6％其中TIMI-3级血流占96．3％，明显高于溶栓治疗50％～70％的再通率，住院死亡率为2．8％。病人从急诊室到导管室开始动脉穿刺的时间（door to needie）为30min左右。随访病人195例，平均随访时间19个月（3～35个月）。复发缺血病人（复发心绞痛并伴有心电图缺血性改变）21例（10．8％），5例发生再梗死，均重复行介入治疗。结论急诊PCI是抢救急性心肌梗死、改善远期预后的有效方法，具有较大推广应用价值。

Clinical study of primary percutaneous coronary intervention in treatment of acute myocardial infarction

Objective To evaluate the safety and feasibility of primary percutaneous coronary intervention in patients with acute myocardial infarction. Methods From Dee. 1999 to Dee. 2004, 207 consecutive patients with AMI underwent P - PCI in our hospital and 195 were followed - up by means of letters or phone. We compared the effectiveness of patients with P - PCI and intravenous thrombolysis. Results Infarct related arteries pateney achieved in 97.6% , TIMI 3 in 96.3%. The IRA pateney rate was higher than that of thrombolysis therapy. The average time from door to needle was 30minutes. Recurrent isehemia was found in 21 eases, reinfaretion in 5 eases. Conclusion P - PCI is effective for patients with AMI and feasible in experienced hospitals.