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1、急性心肌梗死直接、延迟及补救性PCI治疗的比较研究作者：滕旭吴桂平张彦红贾大林【摘要】冃的对比急性心肌梗死成功直接、延迟及补救性PCI治疗的近期疗效和远期疗效。方法共纳入286例首发心梗患者，既往无心衰病史。按入院时间分别接受直接、延迟及补救性PCT治疗，均治疗成功。观察三组住院期间和随访期间主要心脏不良事件(MACE,即死亡、再发心绞痛、再次梗死、心力衰竭)和超声心动图的变化。结果住院期间三组患者各项心脏事件差异均无显著性(P>0.05),复合终点事件发生率，差异亦无显著性。平均随访(13・1±3・5)个月
2、时，三组患者在死亡、不稳定型心绞痛、再次梗死发生率方面无明显差异(P>0.05),但心力衰竭和复合终点事件发生率，补救PCI组明显下降(P<0.05)o左心室射血分数及左心室短轴缩短率，溶栓后补救性PCI组明显大于延迟PCI组(P<0・05)。延迟PCI组和直接PCI组差异无显著性(P>0.05)o左心房内径及左心室舒张末内径，溶栓后补救性PCT组显著低于延迟PCT组(P<0・05),延迟PCT组和直接PCI组差异无显著性(卩〉0・05)o结论静脉溶栓联合PCI治疗AMI可实现TRA的尽早、
3、充分、持久开通，可获得与直接PCT相同冠脉造影疗效的同时患者左心室功能显著改善，并不增加MACEo【关键词】急性心肌梗死介入治疗预后EffectionofdirectdelayedandthrombolysispluspercutaneouscoronaryinterventionTENGXu,WUGui-Ping,ZHANGYan-hong,eta1.DepartmentofCardiology,ShenzhouHospitalAffiliatedtoShenyangMedicalCol1ege,Sheny
4、angl10002,China【Abstract】Object!veToevaluatethecurativeeffectonacutemyocardialinfarctionintheshort-termandlong-termstage:direct、delayedandcomplementarypercutaneouscoronaryintervention(PCI)・MethodsAtotalof286PCIpa.tientswithAMIweredividedinto3groups:directPC
5、I,delayed卩ClandthrombolysisplusPCIaccor'dingtothepatientsregistrationdate・Therewasnorecordofheartfai1ureoccurrenceinthecasehistoryforallofthem,andallofthemaretreatedsuccessfu1ly.Duringhospitaiizationandfol1ow-upperiodweobservedmajoradversecardiacevents(MACE
6、:death,recurrentangina,re-infarction,heartfailure)andtheechocardiographychangesofthethreegrouppatients・ResultsDuringhospitaiizationtheincidenceofMACEandcompositeendpointeventratewerenotdifferentinthe3groups(P>0.05)・Theincidenceofdeath,unstableanginaandre
7、~infarctionwerenotdifferentinthe3groupsduring(13.1土3.5)monthsfol1ow-upperiod(卩>0.05)・Buttheincidenceofheartfailure,compositeendpointeventweresignificantlydecreased(P<0.05)inthrombolysisplusPCTgroup・Theleftventricularejectionfractionandleftventriculars
8、horteningfractioninthrombolysisplusPCTgroupweresignificantlyhigherthandelayedPCIgroup.AnditwasnotsignificantlydifferentbetweendelayedPCTanddirectPCTgroup・Theparametersofleftatrialdiameterandleftventric
