【摘要】 目的观察高龄(≥75岁)急性心肌梗死(AMl)患者溶栓治疗的疗效和安全性。方法将49例高龄(≥75岁)AMI患者随机分成溶栓组(24例)和对照组(25例),溶栓组在常规治疗基础上采用尿激酶(UK)静脉溶栓加口服阿斯匹林,对照组除不用UK外其余治疗均与溶栓组相同。结果血管再通率溶栓组显著高于对照组(62.5%及12.0%,P<0.05);溶栓明显改善了高龄AMI患者的左室射血分数(61.3%及50.8%,P<0.05);溶栓显著降低了高龄AMI患者的住院病死率(36.0%对12.5%,P<0.05),降幅为23.5%;溶栓组未见严重出血等并发症。结论对无禁忌症的高龄AMI患者进行溶栓治疗,可以增加其血管再通率,改善心功能及降低病死率。更多还原

【Abstract】 Objective To investigate the effects and safety of thrombolytic th erapy in senile patients with acute myocardial infarction(AMI). Methods forty n ine elder patients with AMI were divided into 2 groups,thrombolytic therapy grou p (24 cases) and control group (25 cases).Thromb olytic therapy group was treate d with combined therapy of intravenous urokinase(UK) plus oral acetylaslicylic a cid and conventional medicines;control group was treated with conventional medic ines only. Results The clinical repatency rate was significantly higher in throm bolytic therapy group than in control group (62.5%vs 12.0%,P<0.05).Left ventri cular ejection fraction of elderly patients with AMI was improved by thrombolyti c therapy (61.3%vs 50.8%,P<0.05). compared to control group,a 23.5%reduction of the mortality during 4 weeks of hospitalization was found in thrombolytic the rapy group (P<0.05).No serious hemorrhage complications occurred in thrombolytic therapy group. Conclusions In the absence of contraindication,administration of intravenous urokinase to elderly patients with AMI results in increased reperfu sion rate and improved left ventricular function as well as lower mortality.更多还原