静脉溶栓治疗老年急性心肌梗死临床分析

目的探讨老年(≥60岁)急性心肌梗死(AM I)患者静脉溶栓治疗的临床疗效。方法老年AM I患者59例,经静脉尿激酶(UK)溶栓治疗患者21例为UK溶栓组,同期未溶栓治疗患者38例为未溶栓组,除不用尿激酶以外,其余治疗均与UK溶栓组相同。结果UK溶栓组冠脉再通率为66.7%(14/21)。UK溶栓组4周病死率为4.8%(1/21),常规治疗组为18.4%(7/38),两组差异有统计学意义(P<0.05)。UK溶栓组严重的心律失常率为28.5%(6/21),未溶栓组为52.6%(20/38),两组差异有统计学意义(P<0.05)。结论尿激酶静脉溶栓治疗老年急性心肌梗死可提高再通率,降低病死率,减少心力衰竭发生,改善预后。

The analysis on intravenous thrombolytic therapy in the elderly with acute myocardial infarction

Objective To investigate the clinical efficacy of intravenous thrombolytic therapy for the elderly （ ≥60 years） with acute myocardial infarction （AMI）. Methods 59 aged cases with AMI were divided into two groups, in which 21 cases of intravenous urokinase （UK） thrombolysis were divided into thrombolysis group （group A）, and 38 cases of non-thrombolysis in synchronization into non-thrombolysis group （group B） with the same therapy as thrombolysis group except UKResults Coronary recanalization rate and mortality rate in group A were 66.7% and 4.8% respectively, which were higher those in group B （ P 〈 0. 05 ）. Serious arrhythmias rates in group A and group B were 28.5% （6/21） and 52.6% （20/38） ,which were significantly different （P〈0.05）. Conclusion Urokinase intravenous thrombolytisis for the elderly patients with acute myocardial infarction can increase recanalization rate, reduce the mortality rate and improve the prognosis.