Takizawa A, Nagao M, Yamamoto K, Urabe T, Aoshima S, Gen T
Division of Cardiology, Shizuoka City Hospital, Japan.
Jpn Circ J. 1988 Mar;52(3):211-8. doi: 10.1253/jcj.52.211.
We retrospectively compared the efficacy of percutaneous transluminal coronary angioplasty (PTCA) and intracoronary thrombolysis (ICT) in patients with acute myocardial infarction (AMI). The ICT group consisted of 62 consecutive patients who underwent ICT before the introduction of PTCA for AMI and who were considered to be candidates for PTCA based on review of their cine-films. The PTCA group consisted of 92 consecutive patients who underwent PTCA thereafter. The reperfusion rate was significantly higher in the PTCA group than in the ICT group (92.4% vs 71.4%, p less than 0.01) and the residual stenosis was significantly lower in the former. Furthermore, the incidences of reinfarction and post-infarction angina were significantly lower in the former than in the latter (3.3% vs 12.9%, p less than 0.05 and 6.5% vs 29.0%, p less than 0.001 respectively). Although the degree of improvement in left ventricular function was influenced by the result of reperfusion, it was not affected by the reperfusion method. Therefore, PTCA did not improve left ventricular function more than ICT unless ICT alone failed to achieve reperfusion.
我们回顾性比较了经皮腔内冠状动脉成形术（PTCA）和冠状动脉内溶栓术（ICT）对急性心肌梗死（AMI）患者的疗效。ICT组由62例连续患者组成，这些患者在PTCA用于AMI之前接受了ICT治疗，并且根据其电影造影复查结果被认为是PTCA的候选者。PTCA组由92例此后接受PTCA的连续患者组成。PTCA组的再灌注率显著高于ICT组（92.4%对71.4%，p<0.01），且前者的残余狭窄显著更低。此外，前者的再梗死和梗死后心绞痛发生率显著低于后者（分别为3.3%对12.9%，p<0.05和6.5%对29.0%，p<0.001）。尽管左心室功能的改善程度受再灌注结果影响，但不受再灌注方法影响。因此，除非单独使用ICT未能实现再灌注，否则PTCA在改善左心室功能方面并不比ICT更有效。
