老年人AMI发病后不同时间溶栓治疗对梗死相关血管再通疗效的观察

Observation on thrombolytic therapy on blood vessel reperfusion by different times after senile patients with AMI

目的:观察急性心肌梗死(AMI)发病后不同时间溶栓治疗对血管再通的影响。方法:85例70岁以上AMI静脉溶栓治疗患者,根据发病后不同时间溶栓分为≤2h、2～4h、4～6h、6～12h和12～24h5组。结果:5组血管再通率分别为84.6%、76.9%、68.8%、45.6%和50%,前3组与后2组间比较,差异有显著性意义(P<0.05);病死率分别为0、2.6%、12.5%、18.2%和16.7%;开始溶栓至血管再通所需时间与发病至溶栓时间呈正相关(P<0.05),发病2h内为35～80mim,6～12h则为90～155min。结论:70岁以上AMI患者发病6h内溶栓治疗血管再通效果最好,但对于发病时间6～12h和12～24h的患者溶栓治疗仍有较好的效果,可减少并发症。

Objective： To study the effect of thrombolytic therapy on blood vessel reperfusion by different times after acute myocardial infarction （AMI）. Methods：Eighty five senile patients with AMI were divided into five groups according to different times after intravenous thrombolytic therapy. They were ≤2 h,〉2-4 h,〉4-6 h,〉6-12 h and 12-24 h group. Results：Reperfusion rate of the 5 groups were 84.6%,76.9%, 68. 8%,45.6% and 50% respectively, with significant difference between the former three groups and the latter two groups（ P〈0. 05）. The mortality rate were 0,2.6% ,12. 5%,18.2% and 16.7% respectively. The time from the beginning of dissolving to blood vessel reperfusion was positively related with the time from onset of AMI thrombolytic therapy（ P〉0. 05）. Only 35-80 minutes within 2 hours after onset of AMI,but 90-155 minutes within 6-12 h. Conclusions：In the senile patients（over 70 years old）, within 6 after onset of AMI, the reperfusion effect of blood vessels was the best. As for the cases within 6-12 h after the onset of AMI, the thrombolytic effect were also favourable and reduced the complication,