急性心肌梗死溶栓治疗对住院病死率的影响

目的 评价溶栓治疗对急性心肌梗死(AMI)的近期疗效。方法 对自1989年9月～1998年4月收治的AMI患者906例分别以溶栓冠脉再通、未再通与未溶栓三组的住院病死率及其影响因素作比较。结果 溶栓再通组死亡率明显低于未再通组(5.2％,15.5％,P<0.01)。AMI合并室颤、室速、急性肺水肿、心源性休克的病人,再通组的住院病死率明显低于未再通组(P<0.01)。而溶栓组死亡率与溶栓未再通组死亡率无显著性差别(P>0.05)。结论 溶栓再通对降低住院病死率具有独立的良好作用。

Observation of effects of thrombolytic therapy on in-hospital mortality in patients with acute myocardial infarction

Objective To study the effects of thrombolytic therapy on acute prognosis in patients with acute myocardial infarction. Methods 906 cases since September 1989 to April 1998 in our hospital, including 192 cases experienced reper-fusion,161 cases non-reperfusion and 549 cases non experienced thrombolysis.the in-hospital mortality and its effective factors were compared. Results That cases in-hospital mortality of the reperfusion group (5. 2%) was significantly lower than that of non-reperfusion group(15. 5%)(P<0. 01). Moreover,the different of mortality in patients complicated with ventricular fibrillation, ventricular tachycardia,acute pulmonary edema and cardiogenic shock between reperfusion group and non-reperfusion group were still significant (P < 0. 01). While the in-hospital mortality of non-thrombolytic group and non-reperfusion group were 12. 2% and 15. 5% respectively (P>0. 05). Conclusion Reperfu-sion has an independent effect on decreasing the in-hospital mortality of patients.