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【medical-news】ST段抬高型心肌梗死溶栓与血管成形
28 January 2008
MedWire News: Patients with ST-elevation myocardial infarction (STEMI) have similar left ventricular ejection fraction (LVEF) and rates of inducible ventricular tachycardia after treatment with thrombolysis as they do after primary angioplasty, Australian researchers report.
Primary angioplasty has become the preferred treatment for STEMI, but intravenous thrombolysis remains the first-line treatment in 30% to 70% of cases worldwide, the authors explain.
Pramesh Kovoor, from the University of Sydney, and colleagues therefore compared LVEF and rates of inducible ventricular tachycardia in 225 patients treated with primary angioplasty and 195 patients receiving thrombolysis for STEMI.
Mean LVEF was similar in both groups, at 48% for patients treated with primary angioplasty and 46% for those receiving thrombolysis.
Electrophysiologic studies were carried out in patients with LVEF lower than 40%, with about 30% of patients in each group.
Ventricular tachycardia was inducible in 23 (34.8%) of 66 primary angioplasty patients compared with 21 (38.1%) of 55 thrombolysis patients, a nonsignificant difference.
Thirty patients received implantable cardiac defibrillators, of whom 27% had appropriate device activations for tachyarrhythmias during a follow-up period of 570 days. The mean time from STEMI to first spontaneous activation was 387 days.
There were no significant differences between the treatment groups.
Kovoor and co-workers conclude in the American Journal of Cardiology: "The results suggest that patients treated with thrombolysis achieve similar preservation of LVEF and susceptibility to inducible ventricular tachychardias compared with patients treated with primary angioplasty."
They add: "There was a surprisingly high rate of spontaneous defibrillator activations, often occurring late after MI."
Am J Cardiol 2008; 101: 153-157
http://www.incirculation.net/NewsItem/Similar-outcome-after-thrombolysis-or-primary-angi.aspx 有一篇类似的文献“Relation Between Hospital Primary Angioplasty Volume and Mortality for Patients With Acute MI Treated With Primary Angioplasty vs Thrombolytic Therapy ”，它的结论是：In this study, patients with AMI treated at hospitals with high or intermediate volumes of primary angioplasty had lower mortality with primary angioplasty than with thrombolysis, whereas patients with AMI treated at hospitals with low angioplasty volumes had similar mortality outcomes with primary angioplasty or thrombolysis.
我的问题：
1. 这篇文献与楼上的有什么关联
2. 我们对疾病的理解越来越深刻，治疗方法不断改进，许多新概念被提出来，以前的一些结论还能不能沿用至今？现在的一些结论不管是和以前的相左还是细化，怎么理解分析关联？如果心梗再出来个什么分类法，难道这两种治疗方法也再对比研究一次。
JAMA. 2000;284:3131-3138.全文链接见下
http://jama.ama-assn.org/cgi/content/full/284/24/3131 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Similar outcome after thrombolysis or primary angioplasty in STEMI
28 January 2008
ST段抬高型心肌梗塞溶栓与直接血管成形术转归相似
2008年1月28日
MedWire News: Patients with ST-elevation myocardial infarction (STEMI) have similar left ventricular ejection fraction (LVEF) and rates of inducible ventricular tachycardia after treatment with thrombolysis as they do after primary angioplasty, Australian researchers report.
MedWire新闻：澳大利亚研究人员报道，对于ST段抬高型心肌梗塞患者，溶栓治疗与直接血管成形术比较，可诱发室性心动过速（？不知是否指再灌注室性心动过速）的比率及左室射血分数相当。
Primary angioplasty has become the preferred treatment for STEMI, but intravenous thrombolysis remains the first-line treatment in 30% to 70% of cases worldwide, the authors explain.
作者说明，直接血管成形术已成为ST段抬高型心肌梗塞首选的治疗方法，但是在全世界30％－70% 的此类患者中，静脉内溶栓仍然是一线疗法。
Pramesh Kovoor, from the University of Sydney, and colleagues therefore compared LVEF and rates of inducible ventricular tachycardia in 225 patients treated with primary angioplasty and 195 patients receiving thrombolysis for STEMI.
因此，来自悉尼大学的Pramesh Kovoor及其同事针对ST段抬高型心肌梗塞患者，比较两种治疗方法左室射血分数及可诱发室性心动过速的比率，其中225名患者行直接血管成形术、195名患者接受溶栓治疗。
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作者:admin@医学,生命科学 2011-06-17 18:08
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