贫血对急性心肌梗死药物溶栓治疗的影响

To Study the Effection of Snaemia Having on the Efficacy of the Treatment of Acute Myocardial Infarction Through Thrombolysis

目的了解贫血对急性心机梗死药物溶栓治疗的影响。方法我院1999～2005年接受药物溶栓治疗的急性心肌梗死患者193例,诊断为贫血的患者67例,无贫血患者126例,比较2组的临床特点、病死率及主要心脑血管不良事件(MACCE)的发生情况,平均随访539d。结果贫血患者溶栓再通率明显低于无贫血患者(38.8%:61.1%,P<0.001),而低血压的发生率(29.9%:21.4%,P<0.001),心衰的发生率(19.4%:11.1%,P<0.001),心律失常发生率(55.2%:36.5%,P<0.001),病死率(8.9%:3.2%,P<0.001)和MACCE发生率(13.4%:9.5%,P<0.05)均明显增高,左室射血分数明显降低,P<0.001。结论贫血是影响急性心机梗死药物溶栓疗效及预后的独立危险因素。

Objective To observe the efficacy of domestic clopidogrel and import one in treatment of unstable angina.Methods 193 patients were suffered from acute myocardial infarction （AMI） from 1999 to 2005 who were received thrombolysis.67pats suffered anaemia at the same time （group 1）.The other 126 pats didn＇t suffered （group 2）.Observation of the clinic characteristic,mortality,and main adverse cardiovascular event （MACE）,following 539 days averagely.Results There is no significant different statistically between the two groups.Conclusion group 1 has less rate of thrombolysis repatency,（38.8% vs 61.1%,P〈0.001）,and has more hypotension,（29.9% vs 21.4%,P〈0.001）,more heart failure（19.4% vs 11.1%,P〈0.001）,more arrhythmia（55.2% vs 36.5%,P〈0.001）,more mortality（8.9% vs 3.2%,P〈0.001）and more MACE （13.4% vs 9.5%,P〈0.05）.Both domestic clopidogrel and import one have the same good clinical efficacy in in the treatment of unstable angina.Conclusion Anaemia is a independent risk to the efficacy of the treatment of AMI through thrombolysis.and have bad effect on prognosis.