337例急性心肌梗死静脉溶栓临床分析

337 cases of acute myocardial infarction clinical analysis of intravenous thrombolysis

目的探讨337例急性心肌梗死（AMI）患者静脉溶栓过程中影响成功率的关键因素。方法回顾性分析笔者所在科自1997年至2006年对收治的337例AMI患者进行静脉深栓的情况。按治疗时间、年龄、梗塞部位、糖尿病史、是否合并严重并发症进行分组，计算各组溶栓成功率并将各项结果进行统计学分析。结果2h内的溶栓成功率90．1％，6h内76．4％，6—12h内44．9％（P〈0．05）。非老年组（〈70岁）的溶栓成功率74．5％，老年组（≥70岁）57．5％（P〈0．05）。单一壁范围梗死溶栓成功率73．7％，复合壁47．5％（P〈0．05）。糖尿病组溶栓成功率52．3％，非糖尿病组74．1％（P（0．05），合并有严重并发症溶栓成功率50．4％，未合并有严重并发症87．1％（P〈0．05）。结论患者就诊时间、高龄、多支血管病变、糖尿病史、合并有严重并发症是影响静脉溶栓成功率的关键。

Objective To determine the key elements which influence success rate of vein thrombolysis in 337 acute myocaridial infarction （AMI）. Methods We retrospectively analyzed factors associated with vein thrombolysis in 337 AMT patients who take in and give treatment by our cardiovascular. Care unit from 1997 to 2006. The patients were divided to groups according treatment time, age ,infarction, position, diabet, injury compilation. Calulate success rate of thrombolysis of each group and statistical analysis. Results The success rate of thrombolysis in two hours is 90. 1%, in six hours is 76. 4%, 6-12 hours is 44. 9% （P〈0.05） un-oldgroup （〈70） is 74,5%, old group （/〉70） is 57.5% （P〈0.05）. Single section group is 73.7%, more section group is 47.5% （ P 〈0. 05 ）. Diabet group is 50. 3%, un - diabet group is 74. 19%, （P 〈0. 05）. Injury compliation group is 50. 4% , none compliation group is 87.1% （P 〈0.05 ）. Conclusion Treatment time, advanced age, multivessel coronary artery disease, Diabet and injury compliation are key element which influenced the success rate of vein thrombolysis.