急性心肌梗塞溶栓再灌注的临床评价

Clinical evaluation of reperfusion of early-thrombolysis for acute myocardial infarction

为评价急性心肌梗塞（ＡＭＩ）溶栓再灌注的临床价值，对７６例ＡＭＩ病人进行尿激酶静脉溶栓治疗。溶栓后有再灌注的４７例病人作为再通组，无再灌注的２９例为未通组。结果显示，在梗塞的急性期，再通组的严重心脏事件的发生率明显低于未通组，而且无一例死亡，未通组死亡２例。再通组的外周血白细胞计数、心电图的ＱＲＳ记分和ＮＹＨＡ心功能分级均明显低于未通组。溶栓后４周及６个月再通组的左室射血分数均显著高于未通组，室壁瘤的发生率显著低于未通组。提示ＡＭＩ早期成功溶栓可显著改善临床预后及左心功能。

To evaluate the clinical efficacy of reper fusion after early-thrombolysis, 76 pateints were acceptedurokinase thrombolytic therapy within 6 hours after AMI.Clinical signs of reperfusion appeared in 47 patients (groupRP) and not in 29 Patients(group NRP). The inicdence ofcardiac events in group RP and in group NRP is 23.4% and62. 1% repectiviy(p＜ 0.01). Four- Week's left ventric ventricular ejection fraction after thrombolysis is 46. 7± 7. 1 % ingroup RP and in group NRP, respectively(bath P＜ 0.01 ).There is significant lower NYHA cardiac functional class andlower white blood count in group RP than in group NRP.This study has shown the successful reperfusion of early thrombolysis can Preserve left ventricular function and reducethe rate of cardiac events in patients with AMI.