降低急性心肌梗塞病死率的临床研究

本文分析了1980～1985年收住冠心病监护室246例急性心肌梗塞(AMI)病人的临床资料。该病急性期(8周内)住院病死率1971～1974年为27.0%,1975～1979年为12.8%,1980～1985年降至10.6%。对其发病趋势和主要临床特征进行了总结。认为,病死率下降可能与下列因素有关:严密监护;及时防治心律失常;血管扩张剂治疗心衰;透明质酸酶、尿激酶、极化液缩小梗塞范围等。为进一步降低病死率,今后的研究重点是:防止心脏破裂和再梗塞;加强对老年AMI的防治;调节心脏前后负荷维护心脏泵功能。

Studies on reducing hospital case fatality of the patients with acute myocardial infarction (AMI)

Two hundred and forty six patients with AMI were admitted to the coronary care unit at the First Affiliated Hospital of Henan Medical University from 1980 to 1985. The hospital case fatality of the diseases in its acute stage (eight weeks af-ter onset) decreased. It was 10.6% from 1980 to 1985,while those from 1971 to1974,1975 to 1979 were 27.0% and 12.8% respectively. The trends of incidence and themain clinical features of the disease were investigated. The decline of the hospitalcase fatality may be attributed to close monitoring, the prompt and effective pre-vention and treatment of severe arrhythmias, the administration of vasodilator totreat heart failure and the use of GIK solution, hyaluronidase and urokinase tolimit the extent of the infarct area. In order to get the hospital case fatality lower,it is advisable to improve the methods of prevention and treatment of reinfarctionand cardiac rupture,to intensity the prevention and treatment of AMI in the agedand to maintain the pump function by gulating the pre-and-after load.