急性心肌梗死6 h内溶栓与延迟溶栓的疗效评价

目的　观察发病后不同时间溶栓对急性心肌梗死 (acute m yocardial infarction,AMI)的疗效。方法　 95例 AMI患者按发病时间分成 <6 h(46例 )和 6～ 12 h(延迟溶栓 4 9例 )两组 ,观察两组患者的血管再通率、病死率及不良反应发生率。结果　 <6 h溶栓组血管再通率为 76 % ,病死率为 4 % ;延迟溶栓组血管再通率为 4 9% ,病死率为 12 % ,两组比较均有统计学差异 (P均 <0 .0 1)。两组不良反应发生率 (15 %比 16 % )无统计学差异 (P>0 .0 5 )。结论　 6 h内溶栓者再通率高 ,病死率低。延迟溶栓仍有较高的血管再通率 ,对有溶栓适应证者也应积极进行溶栓治疗。

Therapeutic assessment between the thrombolysis in 6 hours and delayed thrombolysis after onset of acute myocardial infarction

Objective To explore the effect of different starting time of thrombolysis on acute myocardial infarction(AMI). Methods Ninety-five patients of AMI were divided into prompt thrombolysis group (less then 6 h, 46 patients) and delayed thrombolysis group (6-12 hours, 49 patients), according to the different starting time of treating AMI. The incidences of reopening and side-effect, as well as mortality were compared between two groups. Results The reopening rate and mortality in prompt thrombolysis group were 76% and 4%, respectively. The reopening rate and mortality in delayed thrombolysis group were 49% and 12%, respectively. Compared the prompt thrombolysis group with the delayed thrombolysis group, there was a significance discrepancy(both P<0.01). The side-effect rate had not significant discrepancy (15% vs. 16%, P>0.05). Conclusion The clinical reopening rate of the thrombolysis is higher in patients with thrombolysis less than 6 hours, the mortality is lower. The thrombolytic treatment should be prompt for patients adapting thrombolysis.