急性心肌梗塞后不同时间溶栓治疗的临床观察

Value of thrombolytic therapy in the different time after acute myoardial infarction

目的:观察急性心肌梗塞(AMI)后不同时间溶栓治疗的临床价值。方法:回顾性分析96例AMI患者的溶栓疗效,根据发病后时间溶栓分为0-2 h,>2-4 h,>4-6 h,>6-12 h四组。结果:四组血管再通率分别为86.7%、78.0%、71.4%、63.2%。早期治疗(0-6 h)组血管再通率(77.9%)与延迟治疗(>6-12 h)组的63.2%相比较,差异有显著性意义(P<0.05);两组五周病死率、反复心绞痛和反复Ⅱ度以上房室传导阻滞(AVB)相比,差异显著(P<0.01)。结论:AMI发病后6 h内溶栓治疗,血管再通效果最好,住院病死率最低,但发病时间>6-12 h的患者溶栓治疗仍可取得较满意的效果。

Objective: To observe the clinical value of thrombolytic therapy in the different time after acute myoardial infarction (AMI). Methods: The 96 AMI patients were divided into 4 groups according to thrombolytic time after AMI: 0-2 h, >2-4 h, >4-6 h, >6-12 h. Results: The reopen rate of blood vessel was 86. 7%, 78. 0%, 71. 4% and 63. 2% in 4 groups respectively. The difference in the reopen rate of blood vessel between earlier therapy (0-6 h) and delayed therapy (>6- 12 h) was significant (77. 9% : 63. 2%),P<0. 05; the difference of mortality,repeating angina pectoris, Ⅱ degree atrioventricular block during 5 weeks between these two groups were highly significant (P <0. 01). Conclusion: Thrombolytic therapy in 6 hours after AMI has better effect but delayed therapy (>6-12 h) still has moderate effect.