溶栓后介入疗法和直接介入疗法治疗急性心肌梗死临床研究.docVIP

溶栓后介入疗法和直接介入疗法治疗急性心肌梗死临床研究 　　[摘要]目的 探讨溶栓后介入疗法和直接介入疗法治疗急性心肌梗死的临床效果。方法 选取本院2014年8月～2016年8月诊治的急性心肌梗死患者132例，采用随机数字表法分为两组，对照组患者66例实施溶栓后介入疗法，观察组患者66例实施直接介入疗法。于治疗前后行心功能评定和临床指标检测，比较两组患者的临床疗效、并发症发生率。结果 治疗后，两组患者的左心室舒张末期内径、左心室舒张末期容积指数、心功能分级均降低，左室射血分数、肌酸激酶同工酶、氨基末端脑利钠肽前体、TIMI血流分级均增加，6 min步行距离增?L（P0.05）。观察组患者治疗后的左心室舒张末期内径、左心室舒张末期容积指数、心功能分级、总并发症发生率均低于对照组（P0.05），左室射血分数、肌酸激酶同工酶、氨基末端脑利钠肽前体、TIMI血流分级、总有效率均高于对照组，6 min步行距离长于对照组（P0.05）。观察组患者术后住院时间短于对照组（P0.05）。结论 溶栓后介入疗法和直接介入疗法均是急性心肌梗死的有效治疗方法，其中直接介入疗法的效果更佳。 　　[关键词]溶栓后介入疗法；直接介入疗法；急性心肌梗死 　　[中图分类号] R542.2+2 [文献标识码] A [文章编号] 1674-4721（2018）1（a）-0037-04 　　[Abstract]Objective To investigate clinical effect of interventional therapy after thrombolysis and direct interventional therapy treating acute myocardial infarction.Methods 132 patients with acute myocardial infarction diagnosed and treated in our hospital were selected from August 2014 to August 2016，and they were divided into the two groups using the random number table method.66 patients in the control group were given interventional therapy after thrombolysis，while 66 patients in the observation group were given direct interventional therapy.Cardiac function assessement and clinical parameters detection before and after treatment were conducted，and clinical curative efficacy and the incidence of complications were compared between the two groups.Results Left ventricular end diastolic diameter，left ventricular end diastolic volume index，cardiac function classification were decreased in patients of the two groups after treatment and left ventricular ejection fraction，creatine kinase isoenzyme，N-terminal pro brain natriuretic peptide，TIMI blood flow classification were increased，6 min walking distance were increased in the two groups after treatment （P 　　[Key words]Interventional therapy after thrombolysis；Direct interventional therapy；Acute myocardial infarction 　　急性心肌梗死是临床常见病，是由于机体冠状动脉粥样硬化斑块破裂而发生的血栓闭塞，以剧烈胸痛、心肌酶学改变、心电图改变为主要临床特征的一种急性缺血性心脏病，具有较高死亡率[1-4]。经皮冠状动脉介入术是临床治疗急性心肌梗死的有效方法，能完全、持