老年人与中青年人急性ST段抬高心肌梗死急诊冠脉介入治疗的疗效分析(1)
[摘要] 目的 探讨老年人与中青年人急性方法ST段抬高心肌梗死急诊冠脉介入治疗的疗效。 方法 随机选取2013年4月—2015年3月收治的急性ST段抬高心肌梗死患者70例，随机分为两组。对照组给予急诊冠脉介入治疗，观察组在此基础上给予替罗非班。 结果 术后两组患者血流2、3级分别比较，差异有统计学意义(χ2=10.21、11.57，P<0.05)。两组患者的ST段均有回落。两组数据进行比较，差异有统计学意义(P<0.05)。 结论 应用替罗非班联合急诊冠脉介入治疗老年人与中青年人急性ST段抬高心肌梗死有较好的疗效。
[关键词] 心肌梗死；ST段抬高；急诊冠脉介入
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2015)11(b)-0096-02
[Abstract] Objective To observe the efficacy of emergent percutaneous coronary intervention for elder， young and middle-aged patients with acute ST-elevation myocardial infarction. Methods 70 patients with acute ST-elevation myocardial infarction admitted to this hospital from April 2013 and March 2015 were randomly divided into control group and observation group. The control group was treated with emergent percutaneous coronary intervention， while the observation group was given tirofiban based on emergent percutaneous coronary intervention. The blood flow situations， ST-segment resolution rate， adverse reaction rate of the two groups were observed. Results After operation， there were statistically significant differences in the rate of TIMI 2 flow， as well as in the rate of TIMI 3 flow， between the two groups， χ2=10.21， 11.57， P<0.05. ST-segment resolution can be found in both the two groups， but that was more evident in the observation group than in the control group with statistical difference， P<0.05. The incidence of MACE was higher in the observation group than in the control group， and the difference between them was statistically significant， χ2=7.05， P<0.05. Conclusion The efficacy of emergent percutaneous coronary intervention for elder， young and middle-aged patients with acute ST-elevation myocardial infarction is good.
[Key words] Myocardial infarction； ST-Elevation； Emergent percutaneous coronary intervention
ST段抬高心肌梗死(STEMA)是冠心病的临床表现中最严重的一种类型，由于冠状动脉发生病变，导致冠状动脉血供急剧减少甚至中断，相应的心肌发生缺血现象，多发于老年人和中青年人[1]。临床上治疗STEMA多是直接采用急诊冠脉介入治疗，但如果再应用抗栓药物进行辅助治疗，效果更好[2]。该研究通过将该院2013年4月—2015年3月的老年人与中青年人STEMA，进行急诊冠脉介入治疗联合溶栓药治疗，取得了较好的疗效，现报道如下。
1 资料与方法
1.1 一般资料
随机选取的70例患者均经冠状动脉造影确诊，为急性ST段抬高心肌梗死。其中男39例，女31例，随机分为对照组和观察组，各35例。对照组男20例，女15例，年龄为(65.3±7.1)岁；观察组男19例，女16例，年龄为(64.9±7.4)岁。两组患者在年龄、性别、文化差异等方面，差异无统计学意义(P>0.05)，具有可比性。
1.2 方法
1.2.1 对照组实验方法 (1)经医院确诊后，首先给予300 mg阿司匹林、300～600 mg氯吡格雷药物，嚼服。
(2)进行血常规、血凝、血型三项检查。实施急诊冠脉造影检查。
(3)给予急诊冠脉介入治疗。
(4)术后给予肝素10 μg/kg，监测并维持患者的活化凝血时间，实施低分子肝素钠，皮下注射3～5 d，依体重调节剂量[3]。
1.2.2 观察组实验方法 在对照组的基础上，予以盐酸替罗非班(欣维灵，武汉远大，批号：20130221)，10 μg/kg 静推，保证3 min内静脉推注完毕。将0.15 μg/(kg·min) 静脉微量泵持续泵入36 h。肾功能不全者，首次给药剂量减半，0.15 μg/(kg·3 min)微量泵静脉推注。 (刘蓉昕 曹文勇)
[关键词] 心肌梗死；ST段抬高；急诊冠脉介入
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2015)11(b)-0096-02
[Abstract] Objective To observe the efficacy of emergent percutaneous coronary intervention for elder， young and middle-aged patients with acute ST-elevation myocardial infarction. Methods 70 patients with acute ST-elevation myocardial infarction admitted to this hospital from April 2013 and March 2015 were randomly divided into control group and observation group. The control group was treated with emergent percutaneous coronary intervention， while the observation group was given tirofiban based on emergent percutaneous coronary intervention. The blood flow situations， ST-segment resolution rate， adverse reaction rate of the two groups were observed. Results After operation， there were statistically significant differences in the rate of TIMI 2 flow， as well as in the rate of TIMI 3 flow， between the two groups， χ2=10.21， 11.57， P<0.05. ST-segment resolution can be found in both the two groups， but that was more evident in the observation group than in the control group with statistical difference， P<0.05. The incidence of MACE was higher in the observation group than in the control group， and the difference between them was statistically significant， χ2=7.05， P<0.05. Conclusion The efficacy of emergent percutaneous coronary intervention for elder， young and middle-aged patients with acute ST-elevation myocardial infarction is good.
[Key words] Myocardial infarction； ST-Elevation； Emergent percutaneous coronary intervention
ST段抬高心肌梗死(STEMA)是冠心病的临床表现中最严重的一种类型，由于冠状动脉发生病变，导致冠状动脉血供急剧减少甚至中断，相应的心肌发生缺血现象，多发于老年人和中青年人[1]。临床上治疗STEMA多是直接采用急诊冠脉介入治疗，但如果再应用抗栓药物进行辅助治疗，效果更好[2]。该研究通过将该院2013年4月—2015年3月的老年人与中青年人STEMA，进行急诊冠脉介入治疗联合溶栓药治疗，取得了较好的疗效，现报道如下。
1 资料与方法
1.1 一般资料
随机选取的70例患者均经冠状动脉造影确诊，为急性ST段抬高心肌梗死。其中男39例，女31例，随机分为对照组和观察组，各35例。对照组男20例，女15例，年龄为(65.3±7.1)岁；观察组男19例，女16例，年龄为(64.9±7.4)岁。两组患者在年龄、性别、文化差异等方面，差异无统计学意义(P>0.05)，具有可比性。
1.2 方法
1.2.1 对照组实验方法 (1)经医院确诊后，首先给予300 mg阿司匹林、300～600 mg氯吡格雷药物，嚼服。
(2)进行血常规、血凝、血型三项检查。实施急诊冠脉造影检查。
(3)给予急诊冠脉介入治疗。
(4)术后给予肝素10 μg/kg，监测并维持患者的活化凝血时间，实施低分子肝素钠，皮下注射3～5 d，依体重调节剂量[3]。
1.2.2 观察组实验方法 在对照组的基础上，予以盐酸替罗非班(欣维灵，武汉远大，批号：20130221)，10 μg/kg 静推，保证3 min内静脉推注完毕。将0.15 μg/(kg·min) 静脉微量泵持续泵入36 h。肾功能不全者，首次给药剂量减半，0.15 μg/(kg·3 min)微量泵静脉推注。 (刘蓉昕 曹文勇)