替普酶溶栓后早期行PCI治療STEMI的有效性研究

楊憲剛

[摘要] 目的 探討瑞替普酶溶栓后早期行經皮冠狀動脈介入術治療ST段抬高型心肌梗死患者的臨床價值。 方法 方便選取該院于2016年2月—2017年8月期間所收治的ST段抬高型心肌梗死患者54例納入該次研究中，根據當時患者入院情況將其分為研究組和對照組，每組各為27例。研究組行易化PCI手術治療，對照組行直接PCI術治療，對比兩組冠狀動脈造影和介入手術后TIMI分級情況、術前、術后心功能對比以及隨訪情況。結果 ①研究組冠狀動脈造影時的TIMI血流2-3級明顯高于對照組，組間對比有統計學意義（P<0.05），但介入干預后兩組最終TIMI血流2、3級患者對比差異無統計學意義（P>0.05）;②術前研究組心功能（55.47±18.55）分和對照組（53.03±6.66）分差異無統計學意義（t=0.643 2 P>0.05），術后研究組（61.31±8.16）分和對照組（59.99±6.57）分對比差異無統計學意義（t=0.654 7 P>0.05）;③研究組27例中出現心臟不良反應共6例，對照組出現8例不良反應，組間對比差異無統計學意義（χ2=0.385 7 P>0.05）。結論 易化PCI手術的應用對ST段抬高型心肌梗死的治療更加有利。

[關鍵詞] 易化PCI手術;直接PCI手術;ST段抬高型心肌梗死;瑞替普酶

[中圖分類號] R5? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）05（c）-0081-03

[Abstract] Objective To investigate the clinical value of early percutaneous coronary intervention for patients with ST-segment elevation myocardial infarction after thrombolytic therapy with reteplase. Methods A total of 54 patients with ST-segment elevation myocardial infarction who were admitted to our hospital from February 2016 to August 2017 were convenient selected and included in the study. According to the admission of the patients at the time， they were divided into study group and control group， 27 cases each. The study group underwent PCI and the control group underwent direct PCI. The TIMI grading， preoperative and postoperative cardiac function comparison and follow-up were compared between the two groups. Results 1.The TIMI blood flow of the study group was significantly higher than that of the control group at 2-3 grades. The comparison between the two groups was statistically significant （P<0.05）， but the final TIMI blood flow of patients with grade 2 and 3 after interventional intervention. There was no difference in contrast （P>0.05）. 2.There was no statistically significant difference between the preoperative group （55.47±18.55）points and the control group （53.03±6.66）points （t=0.643 2， P>0.05）. There was no significant difference between the scores of （61.31±8.16）points and the control group （59.99±6.57）points （t=0.654 7， P>0.05）. 3.There were 6 cases of adverse cardiac reactions in 27 cases in the study group and 8 cases of adverse reactions in the control group. There was no statistically significant difference between the groups （χ2=0.385 7， P>0.05）. Conclusion The application of facilitating PCI is more beneficial for the treatment of ST-segment elevation myocardial infarction.

[Key words] Facilitative PCI surgery; Direct PCI surgery; ST-segment elevation myocardial infarction; Reteplase