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静脉溶栓对急性心肌梗死治疗效果的多因素分析 被引量:2

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摘要 目的探讨影响静脉溶栓(TT)治疗急性心肌梗死(AMI)临床疗效的因素,提高TT治疗水平。方法用logistic回归分析AMI患者TT治疗时间、年龄、梗死部位等11个因素与疗效的关系。比较AMI起病后6、12h内TT组间以及各组与同时段急诊经皮冠状动脉介入治疗(PCI)疗效差异。结果梗死血管再通并存活且无严重溶栓并发症者,TT治疗时间中位数为4h;未再通或死亡或有严重溶栓并发症者TT治疗时间中位数为8h(P<0.01)。TT治疗时间进入回归方程。其他各因素未能进入回归方程。TT组间比较,6h组心绞痛持续时间短为2.41h(P<0.05);再通率、净有效率高分别为75%,69.04%;病死率、心衰发生率分别为12.2%,7.9%,低于12h组的25%,16.7%。与同时段PCI比较,净有效率6h TT组为69.1%,PCI组为80.4%(P>0.05),12hTT组为33.3%、PCI组为81.3%(P<0.05)。结论年龄、性别、高血压史、梗死部位等因素与溶栓疗效无明显关联。治疗时间是影响TT临床疗效的最主要因素,缩短AMI发作至接受治疗的时间是提高TT治疗率和临床疗效的关键。
出处 《中国老年学杂志》 CAS CSCD 北大核心 2007年第22期2201-2203,共3页 Chinese Journal of Gerontology
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