【摘要】 目的比较急性ST段抬高型心肌梗死(STEMI)患者单纯予瑞替普酶静脉溶栓及溶栓后转诊医师行早期冠状动脉介入治疗的疗效。方法回顾性分析我院2013年10月至2015年10月收治的STEMI患者80例,分为两组,观察组40例采用静脉溶栓后联合早期(溶栓后3～24h)经皮冠状动脉介入治疗(PCI)。对照组40例仅给予静脉溶栓,比较两组患者梗死相关动脉(IRA)再通率、ST段下移率、胸痛症状缓解率、主要并发症发生率、住院死亡率及出院后随访1年主要心脏不良事件(MASE)的发生率。结果观察组IAR再通率95.0%显著高于对照组72.5%(P=0.021);ST段下移率82.5%高于对照组57.5%(P=0.032);胸痛症状缓解率82.5%高于对照组72.5%(P=0.026);主要并发症发生率观察组7.5%,对照组5.0%(P=0.13);随访1年MASE发生率观察组17.5%,对照组30.0%(P=0.018)。结论对于STEMI静脉溶栓后联合早期PCI优于仅给予静脉溶栓,且不增加主要并发症发生率。更多还原

【Abstract】 Objective To compare the curative effects of acute ST segment elevation myocardial infarction(STEMI) treated by intravenous Reteplase thrombolysis alone and early percutaneous coronary intervention(PCI)after thrombolysis by referring physicians. Methods Eighty patients with STEMI in our hospital from October 2013 to October 2015 were aanalyzed retrospectively. These patients were divided into two groups: the observation group included 40 cases treated by intravenous thrombolysis combined with early(3～24 hours after thrombolysis) PCI.The rest 40 patients in the control group were given intravenous thrombolytic therapy alone. infarct related artery(IRA) recanalization rate, ST segment depression rate, chest pain remission rate, the incidence of major complications,hospital mortality and major adverse cardiac events(MASE) occurrence rate at the follow-up of 1 year post discharge between two groups were compared. Results The recanalization rate of IAR in the observation group was 95.0%, which was significantly higher than 72.5% in the control group(P=0.021). The ST segment descending rate was 82.5% higher than 57.5% in the control group(P=0.032). The relief rate of chest pain was 82.5% higher than 72.5% in the control group(P=0.026). The incidence of major complications was 7.5% in the observation group and 5.0% in the control group(P=0.13). The incidence of MASE was 17.5% in the observation group and 30.0% in the control group(P=0.018).Conclusion For STEMI, the combination of PCI and intravenous thrombolysis is superior to intravenous thrombolysis alone, and does not increase the incidence of major complications.更多还原