Comparison of the effects of interventional therapy and direct interventional therapy after thrombolysis in the treatment of elderly patients with acute myocardial infarction / 中国基层医药

ABSTRACT

Objective To compare the efficacy and safety of interventional therapy and direct interventional therapy after thrombolysis in the treatment of senile acute myocardial infarction.Methods From January 2014 to July 2017,a total of 110 elderly patients with acute myocardial infarction admitted to the First People's Hospital of Hangzhou were enrolled in this study.The patients were randomly divided into two groups according to the digital table,with 55 cases in each group.The observation group received combination of intravenous thrombolysis and coronary intervention,and the control group received arterial intervention.The blood flow of IRA before and after treatment,TIMI level 3 open situation,cardiac function improvement (including LVEF,LVEDD),and electrocardiogram ST segment down after treatment,chest pain relief,stent implantation success or failure,incidence of complications were compared between the two groups.Results Before treatment,there were no statistically significant differences in the number of TIMI3 blood flow patients(10 cases,15 cases) and number of TIMI3 patients (12 cases,18 cases) between the two groups (P ＞ 0.05).After treatment,those in the observation group increased to 50 cases and 51 cases,respectively.Those in the control group only increased to 39 cases and 40 cases.The observation group increased more significantly (x2 =7.698,P ＜ 0.05).After treatment,the LVEF values of the two groups were increased,the LVEDD decreased significantly.The LVEF [(57.38 ± 4.23) ％] and LVEDD [(44.32 ± 2.93)mm] in the observation group were improved more significantly than those in the control group [(51.07 ± 4.17) ％,(50.09 ± 2.97) mm,t =7.878,10.257,all P ＜0.05].The incidence rate of ST segment depression(92.73％) and chest pain relief rate(90.91％) in the observation group after treatment were higher than those in the control group(65.45％,61.82％,x2 =12.369,12.894,2.633,all P ＜0.05).The total incidence rate of complications of the observation group was 9.09％,which was lower than that of the control group(29.09％),the difference was statistically significant(x2 =7.122,P ＜ 0.05).Conlusion Interventional therapy after thrombolysis in the treatment of elderly patients with acute myocardial infarction,can effectively improve the patients'cardiac function,the effect is significant,safe and reliable,it is worthy of further study.