急性心肌梗塞rt-PA溶栓疗效观察

Observation of curative effect of the acute myocardial infarction rt-PA thrombolysis

目的 :评价急性心肌梗塞 (AMI)患者重组组织型纤溶酶原激活剂 (rt PA)静脉溶栓的疗效。方法 :74例AMI患者分为A组年龄 35岁～ 6 5岁 ;B组年龄 6 6岁～ 80岁 ,各组按发病距溶栓时间≤ 3h ,>3h≤ 6h ,>6h～ 12h再通率比较。结果 :rt PA溶栓再通率≤ 3h 83 3%～ 74 7% ;>3h≤ 6h 86 7%～ 87 5 % ,>6h～ 12h 5 7 1%～ 6 3 7%。≤ 6h和 >6h～ 12h再通率有显著差异。AB两组不同年龄组再通率无显著差异。结论 :rt PA溶栓再通率高且安全无出血及其他副作用 ,溶栓再通率与时间密切相关 ,距发病 6h以内为溶栓最佳时间 ,溶栓再通率与年龄不相关 。

Objective To eualuate the affacsy of rt-pA used i nt ruenously in patients with AMI.Method Seventy four patients with AMI were enrolled which was divided into group A aged from 35 to 65 years of AMI to the beginning of thrombolysis that is less than 3 hours (group Ⅰ) between 3 and 6 hours (group Ⅱ) and old and group B aged from 66 to 80 years old.The two groups were compared according to the time from the onset more than 6 to 12 hou rs (group Ⅲ).Results The reperfusion rate is 83 3%～84 7% in g roup Ⅰ;86 6%～87 5% in group Ⅱ;57 1%～63 7% in group Ⅲ.There is signifi cant difference in reperfusion rate between group Ⅱ and group Ⅲ.There is no di fference in reperfusion rate between group A and B.Conclusion Rep erfusion rate in AMI by using rt-PA is high,that is safe and there are no bleed ing and other side-effect.Reperfusion rate is related with the time from the on set of AMI to the beginning of thrombolysis.The optimal time of thrombolysis is less than 6 hours.from the onset of AMI.Reperfusion rate is not related with age .There is marked significance in promoting the reperfusion rate by using haperin to anti-coagulate in the process of thrombolysis.