急性ST段抬高心肌梗死后不同时间溶栓治疗的临床观察

Value of thrombolytic therapy in the different time after of ST-segment elevation myocardial infarction

目的研究急性ST段抬高心肌梗死(STEMI)发病后不同时间溶栓治疗对血管再通的影响。方法120例STEMI静脉溶栓治疗患者,根据发病后不同时间溶栓分为四组,A组≤2小时,B组2￣4小时,C组4￣6小时,D组6￣12小时。结果四组血管再通率分别为80.9%、76.7%、72.2%、39.4%,前三组与后一组间比较,差异有显著性意义(P<0.05);出血并发症差异无显著性(P>0.05);病死率分别为0%、0%、2.8%、6.1%。结论血管再通率与发病至溶栓的时间呈负相关,STEMI发病2小时内溶栓治疗,血管再通效果最好,2￣6小时次之,但对于发病时间6￣12小时的患者溶栓治疗效果不显著。

Objective To study the effect of thrombolytic therapy on blood vessel reperfusion in different times after ST-segment elevation myocardial infarction （STEMI）. Methods One hundred and twenty patients with STEMI were divided into four groups according to different times after intravenous Thrombolytic therapy. The groups were A≤2 h, B〉2～4 h, C〉4～6 h and D〉6～12 h. Results Reperfusion rate of the four groups were 80.9%, 76.7%, 72.2% and 39.4% respectively, with significant difference between the former three groups and the later one group （P 〈 0.05）. The hemorrhage complication without significant difference of the four groups （P 〉 0.05）. The mortality rate were 0, 0, 2.8% and 6.1% respectively. Conclusion The reperfusion rate was opposite related with the duration from onset of STEMI to thrombolytic. In the patients, within 2h after onset STEMI, the reperfusion effect of blood vessels was the best, within 2～6 h was better, but within 6～12 h had not significant effect.