静脉溶栓对提高急性心肌梗死相关梗死动脉开通率的疗效分析

THE CURATIVE EFFECT ANALYSIS OF INTRAVENOUS THROMBOLYSIS IMPROVING THE TAKE RATE OF ACUTE MYOCARDIAL INFRCTION RELATED INFARCTION ARTERY

目的:观察急性心肌梗死尽早(小于6h)实施静脉溶栓治疗,开通相关梗死动脉恢复心肌血液再灌注的疗效。方法:入选治疗组为2009-01～2010-12在我院急诊就诊的228例急性心肌梗死病人,其中156例来院时发病距就诊时间均小于6h,最短者时间为30min,尽快给予静脉溶栓治疗,间接判断溶栓2h内相关梗死动脉开通情况,以及住院后尽早行冠状动脉造影直接观察相关梗死动脉开通情况,适合PCI治疗者同时进行治疗。对照组为72例来院时发病距就诊时间均超过6h,最长时间为2wk,未经静脉溶栓治疗,给予冠状动脉造影及PCI治疗。结果:静脉溶栓治疗组相关梗死动脉开通率为76.92%,对照组为48.61%,出院时治疗组心功能不全为4.81%,对照组19.44%,均有极显著性差异(P<0.001)。结论:尽早实施静脉溶栓治疗,可提高急性心肌梗死相关梗死动脉的开通率。

Objective：To observe the effect of which acute myocardial infarction implement throm- bolytie therapy early （less than 6 hours） and open infarct - related artery to restore the myocardial reperfusion. Methods：The selected treatment group was 228 patients with acute myocardial infarction who were treated from January 2009 to december 2010 in our hospital emergency department, which 156 cases when they were in hospital the time from the onset of treatment was less than 6 hours and the shortest time was 30 minutes. They were treated with intravenous thrombolytie therapy as soon as possi- ble in order to determine the artery opening condition of related - infarct arterial within 2 hours indi- rectly, as well as the reopening situation of the using coronary angiography as soon as possible after admission and observated directly of infarct - related artery for PCI patients who were treated simuhane- ously. The time of 72 cases in control group who were treated in hospital from onset was more than 6 hours and the maximum time was 2 weeks without intravenous thrombolytic therapy, coronary angiogra- phy and PCI treatment given. Results：The take rate of venous infarct - related artery thrombolysis group was 76.92% while the control group was 48.61%. The heart failure rate was 4.81% in treat- ment group while in the control group it was 19.44%. They were significantly different（ P 〈0. 001 ）. Conclusion：The early implementation of intravenous thrombolytic therapy can improve the take rate of acute myocardial infarction infarct artery patency and restore myocardial reperfusion.