急性心肌梗塞溶栓疗法对室壁瘤形成的影响

The effect of thrombolytic treatment on ventricular aneurysm formation accompanied by acute myocardial infarction

目的：探讨溶栓疗法对室壁瘤形成的影响。方法：溶栓组１７例采用链激酶１５０万单位或尿激酶２００万单位静滴，于３０分钟内滴完后继用硝酸甘油２０μｇ／ｍｉｎ持续静滴４８小时。非溶栓组１７例采用硝酸甘油２０μｇ／ｍｉｎ持续静滴４８小时。平均治疗３周时对所有患者进行超声心动检查及心血池扫描显像检查，分别计算两组室壁瘤的发生率及左心室射血分数均值，并对其差异的显著性进行χ２检验和ｔ检验。结果：溶栓组室壁瘤发生率（１７．６％）低于非溶栓组（５２．９％），两者有显著性差异（Ｐ＜０．０５）。溶栓组左室射血分数均值（０．４５±０．０９）高于非溶栓组（０．３６±０．１４），两者有显著性差异（Ｐ＜０．０５）。结论：溶栓疗法可降低室壁瘤的发生率，提高左室射血分数。

Objective:To investigate the effect of thrombolytic treatment on ventricular aneurysm (VA) formation accompanied by acute myocardial infarction(AMI) and to compare the morbidity of VA formation of thrombolytic and nonthrombolytic group.Methods:17 cases of thrombolytic group were treated with streptokinase 1 500 thousands U or 2 000 thousands U by intravenous drop for 30 minutes,then nitroglycerin was injected for 20μg per minute and continue for 48 hours.17 cases of nonthrombolytic group were treated with nitroglycerin solely 20μg per minute by intravenous drop and continue for 48 hours.Results:The incidence of VA formation was 17 6% in thrombolytic group,that was lower than nonthrombolytic group.There was obvious difference between the two groups( P <0 05).On the other hand,the mean of LVEF was 0 45±0 09 in thrombolytic group,that was higher than nonthrombolytic group(0 36±0 14, P <0 05).Conclusions:The thrombolytic therapy could decrease the incidence of VA formation and enhance the value of LVEF.