不同年龄组急性心肌梗死患者溶栓血管再通率和并发症的对比

目的　旨在对比不同年龄组急性心肌梗死患者溶栓血管再通率和并发症。方法　在冠心病监护病房(CCU) ,根据不同的年龄 ,将用尿激酶治疗的 2 6 6例急性心肌梗死患者 ,分成A组 (年龄 <6 0岁 ,n =111)、B组 (年龄为 6 0～ 6 9岁 ,n =110 )和C组 (年龄≥ 70岁 ,n =45 )。结果　 (1)随年龄的增加冠状动脉梗死相关血管再通率逐渐下降 ,病死率和出血并发症有升高趋势 (P>0 0 5 ) ;(2 )老年人血白细胞、静脉血糖、肌酸激酶均显著高于A组(P <0 0 1,P<0 0 5 ) ;(3)C组肺感染和泵衰竭并发症显著高于A组 (P <0 0 1,P<0 0 5 ) ,心脏破裂并发症亦显著高于B组 (P <0 0 1)。结论　静脉溶栓治疗急性心肌梗死对老年及高龄AMI患者同样有效 ,但尿激酶的剂量应偏小

Comparison of the reperfusion rates of infarct-related artery and the incidences of complications in patients different ages of with acute myocardial infarction receiving intravenous thrombolysis therapy

Objective To compare the reperfusion rates of infarct-related artery(IRA)and the incidences of complications in patienfs of different ages with acute myocardial infarction (AMI) receiving intravenous thrombolysis therapy.Methods In the coronary care unit (CCU),according to the different ages of patients,266 cases of AMI treated with urokinase (UK) were divided into group A (aged <60 years,n=111), group B(aged 60～69 years,n=110)and group C (aged ≥70 years,n=45).Results (1) The reperfusion rate of infarct-related artery decreased and the incidence of hemorrhage complication increased (but P>0.05) with increasing age of the patients (but P>0.05),whereas the hospital mortality;(2)WBC count,blood sugar and,creatine kinase in elderly were significantly higher than those in group A (P<0.01,P<0.05);(3) Incidenas of complications of lung infection and heart failure in group C were significantly higher than those in group A(P<0.01,P<0.05) and incidence of complication of cardiac rupture was significantly higher in group C than in group B(P<0.01).Conclusions This study shows that treatment of AMI with intravenous thrombolysis therapy exerts a beneficial effect on the short-term prognosis of elderly patients including those aged 70 years with AMI.The dosage of UK used should be small.