罗心平,施海明,洪鸣,朱军,倪唤春,李剑,山缨,王彩萍,李勇,范维琥

• 1:复旦大学华山医院心内科
• 2:复旦大学华山医院心内科
• 3:复旦大学华山医院心内科
• 4:复旦大学华山医院心内科

摘要(Abstract)：

目的观察延迟冠状动脉(冠脉)介入治疗(PCI)对急性心肌梗死患者远期疗效的影响。方法回顾性分析1996年1月至2002年10月我院276例急性心肌梗死患者的临床资料,根据患者是否接受介入治疗或接受介入治疗的种类、将患者分为直接急诊PCI治疗组(急诊组)75例,延迟PCI治疗组(延迟组)73例以及常规药物治疗组(对照组)128例。收集并分析住院期间的临床资料,对存活出院的患者随访,记录主要心血管事件(MACE)的发生情况,并于出院第12~48个月进行超声心动图检查。结果基线资料急诊组ST段抬高例数高于其他两组,住院天数明显降低(P<0.05)。住院期间病死率对照组明显高于急诊组和延迟组。平均随访4.3±2.7年(1.8~7.5年),完成随访247人(89.5%)。随访期左心室射血分数(LVEF)值延迟组为57.4%±3.4%,急诊组为59.3%±7.5%,对照组为54.7%±4.1%。延迟组死亡1例,急诊组死亡1例,对照组死亡14例。与对照组相比,延迟PCI治疗可改善心肌梗死患者的左心室功能,降低远期MACE的发生率;与急诊组相比,其左心室功能改善及远期临床事件发生率的降低差异无统计学意义。结论与常规药物治疗相比,延迟PCI治疗可改善急性心肌梗死患者的远期预后。

关键词(KeyWords)： 心肌梗死;血管成形术,经腔,经皮冠状动脉;预后

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 罗心平,施海明,洪鸣,朱军,倪唤春,李剑,山缨,王彩萍,李勇,范维琥

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