溶栓治疗老年急性心肌梗死患者的应用效果及影响因素观察

The effect of thrombolysis in the treatment of elderly patients with acute myocardial infarction and observation of its influencing factors

目的 分析溶栓治疗老年急性心肌梗死患者的应用效果及相关影响因素.方法 研究对象为岳阳市二人民医院在2020年3月-2021年3月收治的80例老年急性心肌梗死患者,所有患者均安排进行溶栓治疗,对比其治疗前后的心功能变化,包括脑钠肽(BNP)以及左心室射血分数(LVEF),同时统计患者治疗效果,根据其治疗效果情况对可能影响其治疗效果的相关因素进行单因素分析和多因素Logistic回归分析.结果 相较于治疗前,80例患者治疗后的BNP指标明显下降,LVEF指标明显上升,差异均有统计学意义(P<0.05).80例患者中治疗显效、有效、无效的例数分别为55例(68.75%)、16例(20.00%)和9例(11.25%),治疗总有效率为88.75%.溶栓就诊时间均值(5.28±1.43)h.性别以及体重对患者治疗效果无明显影响(P>0.05),年龄、溶栓就诊时间以及梗死部位和患者治疗效果密切相关(P<0.05).多因素Logistic回归分析结果显示影响患者治疗效果的独立危险因素分别为年龄以及溶栓就诊时间(P<0.05).结论 对于老年急性心肌梗死患者,溶栓治疗具有良好治疗效果,对患者心功能具有良好改善作用,年龄以及溶栓就诊时间是影响患者治疗效果的独立危险因素,临床需要提高警惕,加强重视.

Ob ject ive Analyze the effect of thrombolysis in the treatment of elderly patients with acute myocardial infarction and related influencing factors.Methods The subjects of the study were 80 elderly patients with acute myocardial infarction admitted to our hospital from March 2020 to March 2021.All patients were arranged for thrombolytic therapy,and their cardiac function changes before and after treatment were compared,including brain natriuretic peptide(BNP)As well as the left ventricular ejection fraction(LVEF),at the same time,the patient's treatment effect was counted.According to the treatment effect,single factor analysis and multivariate logistic regression analysis of related factors that may affect the treatment effect were carried out.Results Compared with before treatment,the BNP index of 80 patients after treatment decreased significantly,and the LVEF index increased significantly,and the difference was statistically significant(P<0.05).Among the 80 patients,55 cases(68.75%),16 cases(20.00%)and 9 cases(11.25%)were markedly effective,effective and ineffective,and the total effective rate of treatment was 88.75%.The mean time of treatment with thrombolysis was(5.28±1.43)h.Gender and weight had no significant effect on the treatment effect of patients(P>0.05),and age,thrombolysis visit time and infarct location were closely related to the treatment effect of patients(P<0.05).The results of multivariate logistic regression analysis showed that the independent risk factors affecting the treatment effect of patients were age and the time of thrombolytic treatment(P<0.05).Conc lus ion For elderly patients with acute myocardial infarction,thrombolytic therapy has a good therapeutic effect and has a good effect on improving the cardiac function of patients.Age and thrombolytic treatment time are independent risk factors that affect the treatment effect of patients.Clinical vigilance and attention should be paid.