【摘要】 目的　探讨静脉溶栓治疗对高龄 (70岁以上 )急性心肌梗死 (AMI)患者的疗效。　方法　对比分析用重组组织型纤溶酶原激活剂 (rt PA) 5 0mg静脉溶栓治疗与非溶栓治疗的高龄AMI患者各 86例住院期间临床疗效。　结果　溶栓组住院期间 4周内病死率 1 2 8%(1 1 86 )明显低于非溶栓组 31 4%(2 7 86 ) (P <0 0 5 ) ,心绞痛、心力衰竭、严重心律失常、心源性休克的发生率明显低于非溶栓组 (P <0 0 5 )。冠脉造影 ,TIMI分级 ,溶栓组梗死相关血管 (IRA)开通率为 6 5 0 %(5 6 86 ) ,距发病溶栓时间 6小时以内IRA开通率为 80 4%(45 5 6 ) ,非溶栓组开通率仅32 %,溶栓病人未发生颅内出血及过敏反应。　结论　提示用rt PA静脉溶栓治疗高龄AMI患者为一种安全有效的方法 ,并有利于AMI的近期预后改善。更多还原

【Abstract】 Objective To investigate the short term effectiveness of rt PA intravenous thrombolytic treatment in the advanced patients with AMI Methods The clinical therapeutic effect,adverse reaction and mortality were analyzed in 86 patients,who treated by the use of rt PA 50mg intravenous thrombolytic therapy,and 86 other patients with AMI were not treated with thrombolytic therapy as the control Results The mortality rate(within 4 weeks) in thrombolytic group was 12 8%(11/86),31 4%(27/86) in non thrombolytic group(P<0 05) In hrombolytic group,the early complications such as heart failure,ventricular rrhythmia,recurrent angina,cardiogenic shock were aslo lower than that in non thrombolytic group(P<0 05),and there overall patency rate of coronary artery was 65 0%(56/86),among them the vascular repatency was 80 4%(45/56) in 6 hours after thrombolytic treatment,in non thromboly tic groups the repatency rate only 32% The intracranial hemorrhage and allergy didnot occur in the thrombolytic patients Conclusion The rt PA intravenous thrombolytic treatment in the advanced peitients with AMI is short term effective and safe更多还原