溶栓治疗时间窗对急性心肌梗死血浆C-反应蛋白水平及疗效的影响

Effect of Thrombolytic Treatment Time on Acute Myocardial Infarction Patients in Their Serum of C-Reactive Protein and Curative Effect

目的探讨溶栓时间窗对急性心肌梗死(AMI)患者血浆C-反应蛋白水平及心肌梗死疗效的影响。方法选择符合WHO规定的AMI诊断标准的108例AMI患者,分为病后0～3h,3～6h,6～12h共3组进行溶栓治疗,并按发病至溶栓时间不同观察比较其ST段下降50%时间、胸痛缓解时间及CK-MB酶峰值提前时间的变化,血管再通率、4周病死率及血浆中CRP浓度的变化。结果 3组比较ST段下降50%时间,胸痛缓解的时间,CK-MB峰值提前时间及各组血液中CRP水平相比,均有显着性差异;3h内溶栓组血管再通率84.3%为最高,3～6h溶栓组血管再通率64.1%为次之,6～12h溶栓组血管再通率27.1%为最低。结论急性心肌梗死静脉溶栓效果与开始治疗时间有依赖关系,溶栓越早再通率越高,血浆CRP水平下降越明显且死亡率越低,并发症越少,愈后越好。

Objective To analyze the effect of different thrombolytie treatment time on acute myocardial infarction patients in their serum of C-Reactive rotein and curative effect. Methods There were 108 patients with AMI were divided into 3 grous,0-3h,3-6h,6-12h,selected in the trial according to the AMI diagnostic standard by WHO. According to the time from AMI onset to thrombolysis, the reductuin rate time of ST after thrombolysis,the lysis time of ain in chest,the advance time of CK-MB and the time of reerfusion rate,death rate were observed and copmared. Results In the three grous,time of the reductuin to 50% at ST,the lysis time of ain in chest,the advance time of CK-MB and the serum of C-Reactive rotein had signigicantly difference. The group thrombolysis within 3 hours had the highest reerfusion rate of 84.3%,3 to 6 hours had the reerfusion rate of 64.1% ,and 6 to 12 hours had the reerfusion rate of 27.1%. Conclusion The effects of intravenous throm- bolytic theray in AMI deend on the treatment starting time. The earlier the treatment starting time,the higher the reerfusion rate,and the lower the death rate and the lower the serum of C-Reactive protein.