阿替普酶治疗老年急性心肌梗死疗效观察

Clinical analysis of alteplase treating acute myocardial infarction in elderly patients

目的探讨阿替普酶治疗老年急性心肌梗死（AMI）的临床疗效。方法184例老年AMI患者完全随机分为对照组和观察组，各92例。2组均进行常规治疗，对照组采用尿激酶，而观察组采用阿替普酶，比较2组的临床疗效、临床症状缓解率及终点事件。结果观察组的总有效率高于对照组[95．7％（88例）比87．0％（80例），P〈0．05]，胸痛症状缓解率及再通率均高于对照组[81．5％（75例）比58．7％（54例），76．1％（70例）比60．9％（56例），均P〈0．05]，再梗死、心绞痛、心力衰竭或休克发生率和病死率均低于对照组，但差异无统计学意义[分别为1．1％（1例）比3．3％（3例）、6．5％（6例）比10．9％（10例）、3．3％（3例）比7．6％（7例）、10．9％（10例）比15．2％（14例）、2．2％（2例）比6．5％（6例），P〉0．05]，平均住院时间明显短于对照组[（11±4）d比（14±5）d，P〈0．05]。结论阿替普酶治疗AMI的临床疗效明显，不良反应少，值得临床推广使用。

Objective To observe the clinical outcome of alteplase treating acute myocardial infarction （AMI） in elderly patients. Methods One hundred and eighty-four cases of elderly patients with acute myocardial infarction were randomly divided into control group and observation group with 92 cases in each group. The two group received routine treatment. The control group was administrated with urokinase, while the observation group was treated with alteplase. Clinical efficacy, clinical symptom remission rate and end point were compared between two groups. Results The total ,efficiency of control group was 87.0% and that of observation group was 95.7%, and the difference was statistically significant. The symptoms of chest pain remission rate and recanalization in ob- servation group were higher than those in the control group（ P 〈 0. 05 ） ; the mean duration of hospitalization in ob- servation group was significantly lower than that in the control group（ P 〈 0.05 ） ; the end event rates were lower than those in control group, but there were not statistically significant. Conclusion Alteplase treating with AMI has cur- ative clinical effect and few adverse reactions.