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目的通过长期观察急性心肌梗死(AMI)后接受急诊经皮冠状动脉介入术(PCI)、单纯静脉溶栓、静脉溶栓+延迟PCI以及未再灌注治疗患者,了解其心功能变化及严重心脏事件的发生情况,以对AMI治疗的几种方法作出评价,更好地指导基层医院治疗。方法选择ST段抬高心肌梗死(STEMI)患者137例,分为再灌注治疗组108例(包括急诊PCI组29例,静脉溶栓组43例,静脉溶栓+延迟PCI组36例)和未再灌注治疗组29例,连续观察3个月至3年,对其心功能变化及严重心脏事件发生情况进行统计比较和分析。结果再灌注治疗组远期严重的心血管事件发生率明显低于未接受再灌注治疗组(P<0.05);LVEF≥50%者高于未再灌注组(P<0.05);动态心电图心律失常发生率无显著差异。其中以急诊PCI组与3 h内溶栓远期效果最佳。结论 AMI后行再灌注治疗与未行再灌注治疗远期疗效有显著差别。其中3 h内溶栓与急诊PCI组,溶栓失败后行补救性PCI与3 h内溶栓及急诊PCI均无明显差异。
Objective To investigate the changes of cardiac function and severe cardiac events in patients undergoing acute percutaneous coronary intervention (PCI), simple intravenous thrombolysis, intravenous thrombolysis plus delayed PCI, and no reperfusion after long-term observation of acute myocardial infarction (AMI) Of the occurrence of several measures to evaluate the AMI treatment to better guide the grass-roots hospital treatment. Methods A total of 137 patients with STEMI were divided into reperfusion therapy group (108 cases), including 29 cases of emergency PCI group, 43 cases of intravenous thrombolysis group and 36 cases of intravenous thrombolysis and delayed PCI group. 29 cases of reperfusion treatment group, continuous observation of 3 months to 3 years, their changes in cardiac function and serious cardiac events were statistically compared and analyzed. Results The incidence of long-term cardiovascular events in reperfusion group was significantly lower than that in non-reperfusion group (P <0.05), LVEF≥50% was higher than that in non-reperfusion group (P <0.05), and ambulatory electrocardiogram arrhythmia There was no significant difference in incidence. Among them, the emergency PCI group and 3 h thrombolytic efficacy of the best long-term. Conclusion The long-term effect of AMI after reperfusion therapy and no reperfusion therapy is significantly different. Thrombolysis within 3 h and emergency PCI group, failed thrombolysis after rescue PCI within 3 h and thrombolysis and emergency PCI no significant difference.