高龄急性心肌梗死患者静脉溶栓治疗的临床观察

目的：探讨高龄（≥75岁）急性心肌梗死（AMI）患者静脉溶栓治疗的疗效和安全性。方法：将61例高龄AMI患者随机分为溶栓组和常规治疗组，溶栓组30例，在常规治疗基础上采用尿激酶（UK）静脉溶栓＋口服阿斯匹林（ASA）。常规治疗组31例，除不用UK外，其余治疗均与溶栓组相同。结果：血管再通率溶栓组为66．7％（20／30），常规治疗组为12．9％（4／31），两组血管再通率比较，差异有显著性（P＜0．05）。溶栓组住院4周病死率为3．3％，常规治疗组为22．6％，两组比较差异亦有显著性（P＜0．05）。溶栓组未见严重出血等并发症。结论：UK＋ASA治疗高龄AMI可以提高冠脉再通率，降低病死率和改善预后。

Intravenous thrombolytic therapy for acute myocardial infarction in the senile patients

Objective To explore the effects and safety of thrombolytic therapy in senile patients with acute myocardial infarction(AMI).Methods sixty one elder patients with AMI were divided into 2 groups,thrombolytic therapy group( n =30) and conventional treatment group( n =31).Thrombolytic therapy group was treated with combined therapy of intravenous urokinase(UK) plus oral acetylsalicylic acid(ASA) and conventional medicines;conventional treatment group was treated with conventional medicines only.Results The clinical repatency rate was 66.7% in thrombolytic therapy group and 12.9% in conventional treatment group,respectively. While the mortality within four weeks was 3.3% in thrombolytic therapy group and 22.6% in conventional treatment group, respectively. Moreover, they were obvious difference between 2 groups(all P <0.05). No serious hemorrhage complications occurred in thrombolytic therapy group.Conclusions Administration of UK and ASA to elder patients with AMI results in increased patency rate and reduced mortality,and improved prognosis.