老年急性心肌梗死不同时间窗溶栓效果的观察

Comparing the effect of thrombolytic therapy on patients with acute myocardial infarction when the therapy is given at different times

目的比较老年急性心肌梗死（acute mrocardialinfarction，AMI）发病后不同时间窗静脉溶栓治疗效果。方法120例老年AMI患者按发病到溶栓治疗开始时间分为〈5h（5h）组和6—12h组（延迟组），在AMI常规治疗的基础上予尿激酶（UK）150万u溶栓治疗。结果5h组血管再通率、4周病死率、严重心衰发生率、半年后左室射血分数（LVEF）分别为71．67％、3．33％、6．67％、（63±8．1）％；延迟组血管再通率、4周病死率、严重心衰发生率、半年后LVEF分别为15．0％、13．33％、12．0％、（51．5±9．5）％两组比较有统计学差异（P〈0．01及P〈0．05），而出血并发症的发生率，两组无统计学差异（P〉O．05）。结论5h组血管再通率，LVEF较高，4周病死率低。

Objective To compare the effect of thrombolytic therapy on acute myocardial patients when it is given at different times after the onset of heart attack symptoms. Methods A total of 120 patiens with acute myocardial infarction were divided into two groups;an early group and a late group. The early group were the patients who had begun to receive the therapy less than 6 hours after the onset of their symptoms, and the late group were the patiens who had begun to receive the therapy more than 6 hours after the onset of their symptoms. In accordance with standard thrombolytic therapy practice, urokinase 1500000U was administered intravenously. Resuits 5 h group vascular recanalization rate, the mortality rate after four weeks, the incidence of serious heart failure,six months after the left ventricular ejection fraction （LVEF） were 71.67% ,3.33% ,6. 67%, （63 ± 8. 1 ） % ; the delayed group vascular recanalization rate, mortality rate four weeks, the incidence of serious heart failure,LVEF after six months were 15.0%, 13.33%, 12.0%, （ 51.5 ± 9. 5 ） %. There was significant difference between the two groups in this respect（P 〈0. 01 ,P 〈0. 05） ,but it should be noted that there was no significant difference in the rate of heamorrage between the two groups （P 〉 0. 05）. Conclusion The 〈 5 h group showed much better results. , not only both vascular recanalization rate and the LVEF were significantly higher than in the delayed group, but also the mortality rate after four weeks was much lower too.