急性心肌梗死早期静脉溶栓治疗的价值

目的观察急性STEMI静脉溶栓治疗的价值。方法选用我院2004年6月-2006年7月收治的STEMI患者63例,分成溶栓组33例,非溶栓组30例。非溶栓组：除不进行溶栓外,治疗方法同溶栓组。溶栓组：均用50mgrt-PA静脉溶栓,观察冠脉再通情况、药物不良反应,并随诊12个月心电图、超声心动图,评价预后。结果治疗组中25例溶栓成功,再通率75.76%。左心功能改善、1级终点事件发生率与对照组比较,差异具有统计学意义（P〈0.05,P〈0.01）。结论静脉溶栓疗法可以改善急性STEMI患者左心功能（左室重构、左室射血分数）,降低Ⅰ级终点事件（MI、猝死）,改善预后。

Value of Intravenous Fibrinolytic Therapy for Early Acute Myocardial Infarction

Objective To observe the significance of intravenous fibrinolytic therapy for patients with ST-segment-elevation myocardial infarction（STEMI）. Methods Sixty-three patients with STEMI treated in our hospital between June 2004 and July 2006 were divided into fibrinolytic group（ therapy group,n = 33 ） and non-fibrinolytic group （control group, n = 30）. The control group was treated with routine treatment,whereas the therapy group received additional 50 mg recombinant tissue-plasminogen activator （rt-PA） based on the routine treatment as the control group. The reperfusion of coronary arterial and side effects of drug were examined and all patients were followed up 12 months with ECG and echocardiography to evaluate the prognosis. Results Intravenous fibrinolytic therapy was successful in 25 cases and the reperfusion rate was 75.76%. There were significant differences in improving left ventricular function and the primary endpoint events rate compared to control group（ P 〈 0.05,P 〈 0.01 ）. Conclusions Intravenous fibrinolytic therapy can improve the left ventricular function（ left ventricular remodeling,left ventricular ejection fraction） and prognosis,and reduce the primary endpoint events rate（ MI. Sudden death）.