论文部分内容阅读
目的 对比直接冠状动脉腔内成形术 (PTCA)及静脉尿激酶 (UK)溶栓对急性心肌梗死 (AMI)治疗的临床疗效。方法 采用观察性队列研究的方法 ,对 97例AMI患者采用UK溶栓 ,60例AMI患者采用直接PTCA治疗 ,比较两组住院期及随访期的超声心动图 (UCG)和临床结果。结果 住院期间UCG检查室壁运动正常者在PTCA组为 (4 6.0 0 % ) ,高于UK组 (2 4.73 % ) (p =0 .0 2 1) ,矛盾运动发生率PTCA组为 0 ,而UK组为 11.83 %。LVEF在PTCA组为 5 6.88± 10 .47,高于UK组 (5 1.5 8± 10 .97) (p =0 .0 41)。住院期心衰发生率UK组为 3 2 .5 9% ,高于PTCA组 (18.3 3 % ) (p =0 .0 2 9)。随访 13 .3 2± 6.86个月累计心衰发生率UK组为 16.2 8% ,也高于PTCA组 (5 .19% ) (p =0 .0 0 1)。住院期间的病死率UK组为 10 .3 1% ,PTCA组为 5 .0 0 % (p =0 .10 0 )。累计病死率UK组为 15 .5 6% ,明显高于PTCA组 (5 .0 0 % ) (p =0 .0 2 1)。 60岁以上年龄组累计的病死率仍然是UK组 (2 8.99% )高于PTCA组 (10 .3 4% ) (p =0 .0 49)。在随访 3、6、12及 2 4个月时PTCA组的生活质量计分各自为 :5 9.90± 14 .67、74.40± 12 .86、73 .86± 9.70、82 .47± 10 .47均高于同时期UK组的计分 (分别是 5 2 .0 8± 14 .49、65 .0 0± 14 .72、67.0 2
Objective To compare the clinical effects of thrombolytic therapy of direct coronary artery angioplasty (PTCA) and intravenous urokinase (UK) on acute myocardial infarction (AMI). Methods By observational cohort study, 97 patients with AMI were treated with thrombolysis in UK and 60 patients with AMI were treated with direct PTCA. The echocardiographic (UCG) and clinical outcomes of both groups during hospitalization and follow-up were compared. Results The prevalence of ventricular wall motion during UCG in hospital was (4.60%) in PTCA group, which was higher than that in UK group (4.73%) (p = 0.021). The incidence of contractile movement was 0 in PTCA group UK group was 11.83%. LVEF was 5 6.88 ± 10.47 in the PTCA group and 5 1.5 8 ± 10.97 in the UK group (p = 0.041). The incidence of HF in hospitalization was 32.95% in the UK group, which was higher than that in the PTCA group (18.3%) (p = 0.029). Follow-up 13.32 ± 6.86 months cumulative incidence of heart failure UK group was 16.28%, also higher than PTCA group (5.19%) (p = 0.001). Mortality during hospitalization was 10.31% in the UK group and 5.0% (P = .10 0) in the PTCA group. Cumulative mortality was 15.56% in the UK group, significantly higher than in the PTCA group (5.0%) (p = .021). The cumulative case fatality rate in the group over the age of 60 was still higher in the UK group (28.99%) than in the PTCA group (10.34%) (p = 0.49). At 3, 6, 12, and 24 months of follow-up, the quality of life scores for the PTCA group were: 5 9.90 ± 14 .67, 74.40 ± 12 .86, 73 .86 ± 9.70, 82.47 ± 10, .47 Higher than the UK group at the same time scoring (respectively 52.08 ± 14.49, 65.0 ± 14.72, 67.0 2