万方,张拓,沈玲红,卜军,宋玮,杜勇平,金叔宣,沈节艳,何奔

• 1:上海交通大学医学院附属仁济医院

摘要(Abstract)：

目的评估急性ST段抬高心肌梗死(STEMI)溶栓后早期经皮冠状动脉介入治疗(PCI)与直接PCI有效性及安全性的差异。方法纳入2010年1月至2011年12月期间在我中心行早期PCI及直接PCI治疗的急性STEMI患者,比较两组住院期间临床终点事件的发生率。采用多因素回归以及倾向积分法计算再灌注策略对临床终点事件的校正相对危险度(RR)。结果早期PCI组共纳入51例患者,直接PCI组共纳入159例患者。两组主要心血管不良事件发生率分别为:早期PCI组4.0%和直接PCI组5.7%(RR=0.647,95%CI:0.155～3.103)。多因素回归校正RR为0.663(95%CI:0.131～3.351),倾向积分法校正RR为0.316(95%CI:0.026～3.879)。安全性终点方面,两组TIMI出血发生率分别为早期PCI组4.0%和直接PCI组1.9%(RR=2.078,95%CI:0.357～12.095)。多因素回归校正RR为2.122(95%CI:0.345～13.070),倾向积分法校正RR为0.302(95%CI:0.010～9.228)。所有结果均未显示差异具有统计学意义。结论对于直接PCI可能延迟的STEMI患者,溶栓后早期PCI治疗是一种有效、安全的替代再灌注策略。

关键词(KeyWords)： 心肌梗死;血管成形术,经腔,经皮冠状动脉;因素分析,统计学

Abstract:

Keywords:

基金项目(Foundation): 国家临床重点专科项目(2011);; 上海市领军人才项目(2012);; 上海市科委优秀学科带头人(XD1402600);; 上海市科委国际合作项目(12410708300)

作者(Author): 万方,张拓,沈玲红,卜军,宋玮,杜勇平,金叔宣,沈节艳,何奔

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