尿激酶静脉溶栓治疗老年急性心肌梗死36例疗效观察

Clinical observation of intravenous thrombolytic therapy with urokinase in 36 cases elder patients with acute myocardial infarction

目的探讨老年急性心肌梗死(AMI)经尿激酶静脉溶栓治疗的临床效果。方法选择2006年2月至2009年2月我院收治的65岁以上老年AMI患者72例,并随机分为两组,观察组则是经尿激酶静脉溶栓治疗患者36例,对照组则是36例,常规治疗给予口服硝酸酯类、β受体阻滞剂、血管紧张素换酶抑制剂、肠溶阿司匹林及护心、对症治疗。结果观察组冠脉再通率为66.67%(24/36),4周病死率为5.56%(2/36),常规治疗组4周病死率为19.44%(7/36),两组差异有统计学意义(P<0.05)。观察组严重的心律失常率为27.78%(10/36),对照组为52.78%(19/36),两组差异有统计学意义(P<0.05)。结论尿激酶静脉溶栓治疗老年急性心肌梗死可提高再通率,降低病死率,减少心力衰竭发生,改善预后,提高了患者的生存质量。

Objective To investigate elderly patients with acute myocardial infarction （AMI） after intravenous thrombolytic therapy with urokinase clinical effect. Methods From February 2006 to February 2009 in our hospital 65 patients with AMI over the age of 72 cases of old age, and randomly divided into two groups, the observation group were treated by intravenous thrombolysis with urokinase in patients with 36 cases, while the control group 36 patients given conventional treatment of oral nitrates,β-blockers,angiotensinfor-enzyme inhibitors, aspirin and heart care, symptomatic treatment. Results Coronary recanalization rate was 66.67% （24/36）, 4-week mortality was 5.56% （2 / 36）, the conventional treatment group was 19.44% （7/ 36）, two groups were statistically significant differences （P〈0.05）. Observer Group rate of serious arrhythmias 27.78% （10/36）, the control group was 52.78% （19/36）, two groups were statistically significant differences （P 〈0.05）. Conclusion The urokinase intravenous thrombolytic therapy in elderly patients with acute myocardial infarction can improve recanalization rates, lower mortality, reduce the occurrence of heart failure and improve the prognosis of patients with improved quality of life.