静脉溶栓联合急诊PCI在急性心肌梗死再灌注治疗中的初步应用
发布时间：2018-08-07 19:28
【摘要】：目的:观察静脉溶栓联合急诊经皮冠状动脉介入治疗(PCI)在ST段心肌梗死(STEMI)再灌注治疗中的疗效性及安全性,为改善我国STEMI再灌注治疗现状提供一种新的方案。方法:纳入就诊于解放军第264医院的发病12小时内的50例STEMI患者,根据患者是否接受静脉溶栓治疗分为溶栓联合急诊PCI组(20例)和直接PCI(pPCI)组(30例)。观察指标中主要终点事件为PCI术前冠状动脉梗死相关血管的TIMI血流分级、PCI术后校正的TIMI血流计帧数(CTFC)、TIMI心肌灌注分级及住院期间主要心脏不良事件(MACE)发生率;次要终点事件为住院期间出血并发症及随访1年内的MACE发生率。结果:两组患者的临床基线指标无明显差异。溶栓联合急诊PCI组在就诊至开始实施再灌注治疗的中位时间明显短于pPCI组(32.0min vs.72.5min,p0.05)。冠状动脉造影后溶栓联合急诊PCI组的罪犯血管TIMI血流分级≥2级的比列明显高于PPCI组(60.0%vs.16.7%,p0.05),溶栓联合急诊PCI组的高负荷血栓比列明显低于pPCI组(20.0%vs.50.0%,p0.05);PCI术后,2组的TIMI血流分级达到3级的比例无明显差异,但溶栓联合急诊PCI组TMPG达到3级的比例明显的高于pPCI组(85.0%vs.53.3%,p0.05),同时术后CTFC帧数也低于pPCI组[(28.5±3.0)vs.(31.5±3.8),p0.05)]。两组住院期间及1年随访期内MACE发生率无明显差异;两组住院期间的出血并发症发生率无明显差异。结论:基于我国当前STEMI再灌注治疗现状,静脉溶栓联合急诊PCI在救治STEMI患者时能够明显缩短实施再灌注治疗时间,同时其疗效性不劣于直接PCI,并且也未增加出血风险,或许能为改善我国STEMI再灌注治疗提供一种有现实意义的参考策略。
[Abstract]:Objective: to observe the efficacy and safety of intravenous thrombolytic therapy combined with emergency percutaneous coronary intervention (PCI) in the treatment of St segment myocardial infarction (St) myocardial infarction with (STEMI) reperfusion, and to provide a new scheme for improving the current status of STEMI reperfusion therapy in China. Methods: 50 patients with STEMI within 12 hours of onset were enrolled. According to whether the patients received intravenous thrombolytic therapy, they were divided into two groups: thrombolytic therapy combined with emergency PCI group (n = 20) and direct PCI (pPCI) group (n = 30). The main endpoint events were the TIMI blood flow grade of coronary infarction related vessels before and after PCI, the corrected (CTFC) / TIMI myocardial perfusion grade and the incidence of major adverse cardiac events (MACE) during hospitalization. Secondary endpoint events were bleeding complications during hospitalization and the incidence of MACE during one year follow-up. Results: there was no significant difference in clinical baseline between the two groups. The median time of thrombolytic therapy combined with emergency PCI group was significantly shorter than that of pPCI group (32.0min vs.72.5 min / p0.05). The ratio of TIMI blood flow grade 鈮，
本文编号：2171115
[Abstract]:Objective: to observe the efficacy and safety of intravenous thrombolytic therapy combined with emergency percutaneous coronary intervention (PCI) in the treatment of St segment myocardial infarction (St) myocardial infarction with (STEMI) reperfusion, and to provide a new scheme for improving the current status of STEMI reperfusion therapy in China. Methods: 50 patients with STEMI within 12 hours of onset were enrolled. According to whether the patients received intravenous thrombolytic therapy, they were divided into two groups: thrombolytic therapy combined with emergency PCI group (n = 20) and direct PCI (pPCI) group (n = 30). The main endpoint events were the TIMI blood flow grade of coronary infarction related vessels before and after PCI, the corrected (CTFC) / TIMI myocardial perfusion grade and the incidence of major adverse cardiac events (MACE) during hospitalization. Secondary endpoint events were bleeding complications during hospitalization and the incidence of MACE during one year follow-up. Results: there was no significant difference in clinical baseline between the two groups. The median time of thrombolytic therapy combined with emergency PCI group was significantly shorter than that of pPCI group (32.0min vs.72.5 min / p0.05). The ratio of TIMI blood flow grade 鈮，
本文编号：2171115
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