Comparative Study Of Acute Myocardial Infarction Efficacy Of Urokinase Combined With Low Molecular Weight Heparin And Percutaneous Coronary Intervention

Objectives:To explore the safety, the efficacy and the value of intravenous thrombolytic therapy and primary percutaneous coronary intervention in acute myocardial infarction, through the study of recent effect and long-term prognosis in different kinds of therapy for 280 patients of both methods.Methods:March 2010-October 2011 in patients with acute myocardial infarction in our hospital 280 cases. intravenous thrombolytic therapy in patients with 175 cases.105 cases of patients with interventional therapy. Clinical data recorded during all patients hospitalized in March 2012-October 2013 to carry out the universality of these cases were followed up, and fill out the survey form. Follow-up treatment group 153 cases.22 cases were lost; follow-up interventional treatment group 92 cases.13 cases were lost, and follow-up rate was 87.5%. Study the symptoms and signs of the patients, the infarct-related artery recanalization rate, cardiac function and two groups of patients during follow-up period of hospitalization, cardiovascular events, mortality, patient deaths and hospitalization time data analysis and the cost of treatment and other indicators, in order to determine the therapeutic effect of the two groups of patients.Results:(1) There is no significant differences in the mean age, sex. onset to treatment time, smoking, drinking, high blood pressure, high cholesterol, diabetes. history of chest pain, cardiac function of two groups of patients (P>0.05). (2) the two groups of patients with recanalization rate difference was significant, with statistical significance (P<0.05). (3) There are two groups of patients with left ventricular end-diastolic diameter and left ventricular ejection fraction obvious difference, with statistically significant(P<0.05). (4) During hospitalization, patients were recurrent angina, heart failure (≥NYHA Ⅲ), malignant arrhythmia, reinfarction, cardiac death, cardiovascular events, bleeding are significant difference with statistical significance (P<0.05). Two-year follow-up after discharge, patients were recurrent angina, heart failure (^NYHA III), malignant arrhythmia, reinfarction, implementing again angioplasty, cardiovascular events, cardiac death are significant difference with statistical significance (P<0.05). (5) Both groups were no significant differences in mortality, no statistically significant (P>0.05). (6) the death of infarction patients were mainly anterior and anteroseptal, the main cause of death was cardiac arrhythmia and pump failure. (7) Length of stay and cost of treatment groups were significant difference, with statistical significance (P<0.05).Conclusions:(1) Thrombolytic therapy and interventional treatment both are effective means of treatment of acute myocardial infarction, and two treatment methods can open infarct-related artery and improve heart function and reduce mortality. (2) Compared with intravenous thrombolysis, the infarct-related vessel patency rate, heart function restore, a low incidence of cardiovascular events, a short number of days in hospital and treatment costs are better(or higher) of percutaneous coronary intervention. (3) Under the status quo, myocardial infarction patients with acute economic capacity should promote the implementation percutaneous coronary intervention, but also should pay attention to thrombolytic therapy.