【摘要】 目的探讨急性心肌梗死(AMI)早期溶栓治疗后再灌注对临床预后的影响。方法选择符合WHO规定的AMI诊断标准的163例AMI患者,按发病至溶栓时间不同比较其再通率、死亡率及出血率。结果总再通率65.6%,出血率11.0%,4周内死亡率9.2%,起病距溶栓6h再通率明显高于6h以后(P<0.01),且死亡率低,不同年龄组6h内再通率差异无显著性(P>0.05);≥70岁组6h再通率低于其他年龄组,差异非常显著(P<0.01);轻度出血率及死亡率与年龄组差异无显著性(P>0.05)。女性组与男性组比较再通率低、死亡率高,差异有显著性(P<0.05)。结论急性心肌梗死静脉溶栓效果与开始治疗时间有依赖关系,溶栓越早再通率越高,且死亡率越低,并发症越少,病后越好。急诊溶栓治疗可获得最佳溶栓时机,提高再通率,宜在基层医院广泛开展。更多还原

【Abstract】 Objective To investigate the effect of reperfusion on clinical prognosis after early-thrombolysis therapy for patients with acute myocardial infarction (AMI).Methods 163 patients with AMI were selected in the trial according to the AMI diagnostic standard by WHO.According to the time from AMI onset to thrombolysis,the reperfusion rate,death rate and bleeding rate were observed and compared.Results The total reperfusion rate amounted to 65.6%,bleeding rate 11.0%,death rate (within 4 weeks) 9.21%。when UK was given within 6 hours after AMI onset,the reperfusion rate was obviously higher than that 6 hours later (P<0.01) and the death rate was lower.When UK was given within 6 hours,there was no significant difference in reperfusion among different age groups (P>0.05).The female’s reperfusion,as compared with that of male,was lower, while the death rate was higher and there was a significant difference (P<0.05).Conclusion The effects of intravenous thrombolytic therapy in AMI depend on the treatment starting time.The earlier the treatment starting time,the higher the reperfusion rate,and the lower the death rate,the fewer the complications and the better the prognosis.Emergenct thrombolytic therapy can get the best thrombolytic opportunity,which can reduce the delaying due to coming to hospital,and can increase reperfusion rate,which is suitable to be used widely in basic hospital in order to obtain the best therapeutic effect.更多还原