急性心肌梗死患者冠状动脉内溶栓疗效分析

An analysis of the effectiveness of intracoronary thrombolytic treatment on acute myocardial infarction in the aged

目的评价老年急性心肌梗死患者冠状动脉（冠脉）内溶栓的疗效。方法急性心肌梗死患者１６０例分为３组：６０～６９岁６８例，７０～７９岁６４例，８０～８５岁２８例。对适宜作溶栓治疗者７７例（３组分别为４０例、３１例及６例）用尿激酶作了冠脉内溶栓治疗。结果５０例溶栓成功，冠脉再通，３组分别为３１例（７７．５％）、１７例（５４．８％）及２例（３３．３％）；８０～８５岁组冠脉再通率明显低于其他２组（Ｐ＜０．０５）。５０例溶栓成功者院内死亡２例（４．０％），８３例未作溶栓治疗者死亡１８例（２１．７％），差异有显著性（Ｐ＜０．０５）。结论冠脉内溶栓成功可降低病死率。

Objective To evaluate the effectiveness of intracoronary thrombolytic treatment with urokinase on acute myocardial infarction (AMI) in the aged. Methods The patients with AMI were divided into 3 groups including 60 69 yrs group 68 cases, 70 79 yrs group 64 cases and 80 85 yrs group 28 cases. The patients with indication of thrombolytic treatment (60 69 yrs group 40 cases, 70 79 yrs group 31 cases, 80 85 yrs group 6 cases) were treated with urokinase intracoronarily. Results Coronary refusion in 60 69 yrs group was 31 cases (77 5%), in 70 79 yrs group was 17 cases (54 8%), and in 80 85 yrs group was only 2 cases (33 3%). The coronary refusion rate of 80 85 yrs group was evidently lower than that of 60 69 yrs and 70 79 yrs groups ( P <0 05). The in hospital death of these 50 cases with coronary refusion was only 2 cases (4 0%), and of the cases without thrombolytic treatment was 18 cases (21 7%)( P <0 01). Conclusions Coronary refusion can reduce in hospital mortality of patients with AMI in the aged.