摘要
目的观察基层医院急性心肌梗死(AMI)早期不同时间溶栓治疗的疗效。方法124例AMI患者按发病到溶栓时间的不同分为5组:A组不超过2h,B组2～4h,C组4～6h,D组6～12h,静脉溶栓后观察各组患者冠状动脉再通率、并发症及死亡率。E组:静脉溶栓后冠状动脉不能再通但尚在发病后6h以内者送外院进行补救性经皮冠状动脉介入治疗(PCI)。结果本组患者冠状动脉再通率总体为67.0%,A、B、C、D组分别是82.1%、75.0%、72.4%、42.9%;总体出血发生率为8.9%,A、B、C、D组分别是0、6.7%、10.3%、17.1%;总体30d内死亡率为8.9%,A、B、C、D组分别是0、3.1%、6.9%、22.9%,冠状动脉再通率、出血发生率、总体30d内死亡率比较,A、B、C组差异无统计学意义(P>0.05),但A、B、C组与D组比较差异有统计学意义(P<0.05)。E组患者5例中4例冠状动脉再通,成功率80%。结论AMI静脉溶栓冠状动脉再通率与时间呈负相关,溶栓时间越早冠状动脉再通率越高,出血并发症越少,死亡率越低,进行补救性PCI可使冠状动脉再通率进一步提高。
Objective To investigate and observe the curative effect of ermergent intravenous thrombolysis in early different time after acute myocardial infarction（AMI）.Methods One hundred and twenty four patients with AMI were divided into 4 groups according to the different time from AMI onset to thrombolysis.Group A were no more than 2 h,group B were 2～4 h,group C were 4～6 h,group D were 6～12 h.To observe the rate of the coronary reperfusion,hemorrhage rate and mortality within 30 days of patients in every group.Results The rate of coronary reperfusion in group A,group B,group C,group D were 82.1%,75%,72.4% and 42.9% respectively.The rate of hemorrhage in the four groups were 0,6.7%,10.3% and 17.1%,and the mortality were 0,3.1%,6.9%,and 22.9% respectively.The rate of the coronary reperfusion,rate of hemorrhage and mortality had no significant difference among group A,group B and group C（P〉0.05）,while the difference was significant compared with group D（P〈0.05）.The coronary reperfusion rate was 80% in group E.Conclusion The coronary reperfusion rate had negative correlation with the time from AMI onset to thrombolysis.The earlier the thrombolytic therapy began,the higher the reperfusion rate was,and the lower the hemorrhage rate and the mortality was.Rescue percutaneous coronary intervention（PCI） could improve the coronary reperfusion rate.
出处
《国际内科学杂志》
CAS
2008年第9期505-507,共3页
International Journal of Internal Medicine
关键词
急性心肌梗死
静脉溶栓治疗
经皮冠状动脉介入治疗
Acute myocardial infarction, Emergent intravenous thrombolysis, Percutaneous coronary intervention
