Intracerebral haemorrhage after thrombolytic therapy for acute myocardial infarction.

Seven cases of intracerebral haemorrhage were identified following the use of thrombolytic therapy in a total of 710 patients with acute myocardial infarction. Each case was reviewed in detail with particular attention to the presenting symptoms. A confusional state was the commonest initial feature. Increased age and male sex were associated with increased risk of cerebral bleed. The possible role of intravenous heparin in increasing risk and the management of affected cases is discussed. Early recognition and action is emphasized.     

急性心肌梗死溶栓治疗失败后补救性血管成形术的疗效

背景:急性心肌梗死溶栓治疗后未出现再灌注的患者采取何种治疗方法更适当仍不明确。比较此类患者接受急诊经皮冠状动脉介入(补救性PCI)与保守治疗的研究资料很少,且尚未见到比较补救性PCI与再次溶栓的研究报道。方法:在英国进行了一项多中心试验,选取427例在溶栓治疗90m in内再     

阿托伐他汀治疗心肌梗死疗效Meta分析

[目的]评价阿托伐他汀治疗心肌梗死的效果及安全性.[方法]计算机检索Cochrane图书馆临床对照试验资料库、Pubmed、中国知网、万方数据库及重庆维普中文科技期刊全文数据库,手工检索药物及心血管相关期刊及会议报告,纳入阿托伐他汀治疗心肌梗死效果的随机对照试验,经质量评估、数据提取对符合标准的随机对照试验进行Meta分析.[结果]共纳入9个随机对照试验,共计789例心肌梗死患者.Meta分析结果显示,与对照组比较,实验组心肌梗死患者给予阿托伐他汀治疗后总胆固醇(TC)水平明显降低(MD=0.97,95%CI:0.85¹.09,P<0.000 01);三酰甘油(TG)水平明显降低(MD=0.75,95%CI:0.671.09,P<0.000 01);三酰甘油(TG)水平明显降低(MD=0.75,95%CI:0.67⁰.83,P<0.000 01);低密度脂蛋白胆固醇(LDL-C)水平明显降低(MD=0.24,95%CI:0.170.83,P<0.000 01);低密度脂蛋白胆固醇(LDL-C)水平明显降低(MD=0.24,95%CI:0.17⁰.31,P<0.000 01);高密度脂蛋白胆固醇(HDL-C)水平明显升高(MD=-0.30,95%CI:-0.370.31,P<0.000 01);高密度脂蛋白胆固醇(HDL-C)水平明显升高(MD=-0.30,95%CI:-0.37^-0.24,P<0.000 01).[结论]阿托伐他汀可有效治疗心肌梗死,明显降低心肌梗死患者的TC,TG,LDL-C水平,明显升高HDL-C;因文献质量较低,影响了结果的准确性,仍需要质量较高的随机对照试验来进行评价.     

Rehabilitation after myocardial infarction

The concept that many patients with asymptomatic coronary atherosclerotic heart disease, including myocardial infarction, can and should return toward normal living is the basis of the rehabilitation effort. The primary care physician is increasingly employing this approach in the care of patients with myocardial infarction. Much of the capacity to effect rehabilitation should be available in the community hospital, in the office of the primary physician, or through community, governmental, public, and voluntary health care agencies and facilities. Although some patients with complex diagnostic problems and more severe impairment require consultative services or referral to specialized cardiac centers, all patients must eventually be returned to the care system and services of their local communities.     

Thrombolytic therapy for myocardial infarction

Thrombolytic therapy has provided a practical means of reducing infarct size and infarct-related mortality. Clinicians must weigh the apparent risks and benefits of thrombolytic therapy: if the ischemic region is large, if treatment can be applied early enough to salvage ischemic myocardium, and if there is no obvious risk of life-threatening hemorrhage, it is likely the patient will benefit from thrombolytic therapy.     

急性心肌梗死的溶栓治疗

急性心肌梗死(AMI)主要是由于斑块破裂诱发局部血栓形成导致血管急性闭塞所致,紧急开通闭塞血管,恢复血流是治疗AMI最有效的方法,目前除急诊介入治疗(PCI)外,溶栓治疗仍不失为快速血管重建的有效方法,特别是在不具备PCI治疗的基层医院,溶栓治疗则为首选治疗。根据大规模临床试验研究,标准溶栓治疗仅适用于ST段抬高AMI患者。     

Causes of death and long-term prognosis after myocardial infarction in patients with diabetes mellitus.

The long-term prognosis and causes of death of myocardial infarction (MI) in 62 diabetics were studied. The mean follow-up time was 6.2 years, 11 patients died in the acute stage of MI, 9 of them (81.8%) had anterior infarction and their major causes of death were ventricular fibrillation and cardiogenic shock (72.2%). 19 died in the follow-up period, 14 of them (73.68%) had inferior and anterior septal infarction; and most died of reinfarction and sudden death. The cumulative survival rate 1, 2 and 5 years after MI was 80.7%, 71.9% and 57.9%, respectively. The results suggest that treatment and prevention of MI in patients with diabetes be more attentive to prevent ventricular fibrillation and cardiogenic shock during the acute stage and in the later stage more attention should be paid to preventing reinfarction. At any stage of the disease, strict diabetic control is of vital importance.

     

心肌梗死后β受体阻滞剂,他汀类药物应用情况的调查

【目的】调查急性心肌梗死(AMI)患服用β受体阻滞剂和他汀类降脂药物的现状，旨在提高临床医师对β受体阻滞剂对于AMI早期及其预后的重要意义和他汀类降脂药物对于AMI患调脂治疗的重要意义。【方法】分析从200—2002年226例因AMI入院的患出院时服用β受体阻滞剂、他汀类降脂药物和抗血小板、硝酸酯类药物的情况，血清胆固醇水平。【结果】从2000—2002年AMI患服用β受体阻滞剂无明显改变，使用率较低，平均为37．6％。他汀类药物的使用情况呈逐年上升的趋势，血清胆固醇水平呈逐年下降趋势，达标率逐年上升，但无统计学意义。【结论】β受体阻滞剂和他汀类药物对于AMI及其预后具有多种有益效应，应加强其应用力度，在临床中应注重血清胆固醇的达标率情况。     

急性心肌梗死行介入治疗后再灌注心律失常的临床效果

目的 探讨急性心肌梗死患者行急诊介入治疗出现再灌注心律失常的效果。方法 选取2017年2月至2019年2月我院治疗的心肌梗死患者136例,以是否出现再灌注心律失常分为研究组和对照组。对照组62例患者均未出现心律失常情况,研究组74例患者均出现心律失常情况。比较两组6个月后的随访情况及心电图电压、开通时间窗时间、住院时间和不良反应情况,并比较两组的血脂参数情况。结果 住院期间:研究组死亡率为2.70%,明显高于对照组的0.00%,差异有统计学意义(P0.05),研究组再梗死率为4.05%,明显高于对照组的1.61%,差异有统计学意义(P0.05);随访6个月:研究组死亡率为1.35%,明显高于对照组的0.00%,差异有统计学意义(P0.05),研究组再梗死率为2.70%,明显高于对照组的1.61%,差异有统计学意义(P0.05)。研究组心电图电压高于对照组,但差异无统计学意义(P0.05),研究组开通时间窗时间及住院时间明显长于对照组,差异有统计学意义(P0.05)。治疗后,研究组LDL-C和TC水平明显低于对照组,差异有统计学意义(P0.05)。结论 急性心肌梗死患者进行急诊介入治疗后,还是会发生因再灌注引发的心律失常及并发症情况。