【摘要】 目的评价半量瑞替普酶溶栓后行易化经皮冠状动脉介入治疗(PCI)对急性ST段抬高心肌梗死(STEMI)患者的疗效和安全性。方法采用前瞻性、开放性的临床研究方法,观察2011年1月至2013年9月在山东省临沂市人民医院接受易化PCI和直接PCI的STEMI患者,分为易化PCI组(65例)和直接PCI组(70例),比较两组患者梗死相关血管(IRA)再通率、左心室射血分数(LVEF)、主要不良心血管事件(MACE,包括心原性死亡、再发心肌梗死、缺血复发、新发心力衰竭或心力衰竭恶化、出血等)发生率。结果易化PCI组再通率95.4%,直接PCI组再通率94.3%,两组患者冠状动脉再通率,术后30 d、3个月、6个月及12个月的LVEF比较,差异无统计学意义(P>0.05);术后30 d、3个月、6个月、12个月内MACE比较,差异无统计学意义(P>0.05)。结论应用半量瑞替普酶(r-PA)对STEMI患者行易化PCI是有效、安全的;在无直接PCI条件的医院,易化PCI是可行的。更多还原

【Abstract】 Objective Compared facilitated PCI with primary PCI in treatment of and study STEMI the effectiveness and safety of facilitated PCI with half-dose reteplase and primary PCI. Methods One hundred and thirty-five patients with STEMI admitted in our department from January 2011 to September2013 were enrolled in the study. The patients received either facilitated PCI after successful thrombolysis with half-dose reteplase( n = 65) or primary PCI( n = 70). The revascularization rates of IRA and MACE rates were compared between the 2 groups 30 days,3 months,6 months and 12 months after PCI. Results The successful revasculatization rates were 95. 4% of IRA in the facilitated PCI group and 94. 3% in the primary PCI group( P > 0. 05). There were no statistical differences between the 2 groups in length of hospital stay,LVEF and MACE rates during follow up( all P > 0. 05). Conclusions Facilitated PCI with half-dose reteplase for STEMI is effective and safe for hospitals not capable of primary PCI.更多还原