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目的对比分析12 h内来院的急性心肌梗死(acute myocardic infarction,AMI)患者采用溶栓、直接冠脉成型术和转院后急诊冠脉成型术治疗方法对AMI患者预后的影响．方法将我院2004年1月至2005年12月因急性心肌梗死12 h内来院的患者采取连续入组的方式分为溶栓治疗组和直接冠脉成型术治疗组,以及外院转院于12 h内行急诊冠脉成型术治疗组,采用r检验和x2检验方法比较3组患者在院期间和出院后1年转归的差别。结果与直接冠脉成型术和转院后急诊冠脉成型术相比,溶栓组到院至再通时间间隔最短[(2．3±1．0)h比(2．1±1．1) h比(1．1±0．2)h,P<0．01],在院病死率(3．2％比4．0%比6．3％)和1年后病死率(4．8％比8．0%比12．5％)最高,但差异无统计学意义,但溶栓组非致死性再梗死的发生率显著高于PCI组(18．8％比4．5％,P<0．05)。结论AmI的救治关键是尽早开通罪犯血管,转院治疗也是较为安全有效的治疗方式。
Objective To compare the effects of thrombolysis, direct coronary angioplasty and posttransmission emergency coronary angioplasty on the prognosis of AMI patients in hospital from 12 months after acute myocardial infarction (AMI). Methods From January 2004 to December 2005 in our hospital, patients admitted to hospital within 12 hours after acute myocardial infarction were divided into thrombolytic therapy group and direct coronary angioplasty group, Emergency coronary angioplasty in the treatment group, the r test and x2 test were used to compare the differences between the 3 groups in the hospital and 1 year after discharge. Results Compared with direct coronary angioplasty and post-transurethral emergency coronary angioplasty, the shortest thrombolysis interval from hospital to recanalization was (2.3 ± 1.0) h (2.1 ± 1.1) h vs (1.1 ± 0.2) h, P <0.01], hospital mortality (3.2% vs 4.0% vs 6.3%) and after 1 year % Vs 8.0% vs 12.5%), but the difference was not statistically significant. However, the incidence of nonfatal reinfarction in thrombolytic group was significantly higher than that in PCI group (18.8% vs. 4.5%, P <0.05). Conclusion The key point of AmI treatment is to open the criminals’ blood vessels as soon as possible, and the transfer treatment is also a safe and effective treatment.