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为探讨放宽急性心肌梗塞(AMI)溶栓指征后.对疗效、安全性及提高溶栓比率影响.观察408例AMl且患者中,进行溶栓治疗的201例选择的主要指征变化及疗效.结果:(1)在按照中华心血管病杂志编委会1991年所推作的AMI济栓方案基础上,进一步放宽入选距发病时间从≤6小时至≤12小时,年龄由≤65岁变为不限,使获选溶栓者占总的AMI患者比率达到49.3%,比未放宽前(28.4%,P<0.001)及GISSl-2(32.8%,P<0.001)等一些大规模临床试验较高.(2)32例AMI在发病>6小时而≤12小时之间溶栓比169例≤6小时,仍有相近的血管再通率(62.5%对71.0%)、及病死率(3.1%对6.5%,P>0.05),比不溶组明显下降(18.4%,P<0.05);(3)69例老年(≥65岁)AMI溶栓患者,比与之匹配的92例未溶栓者的心功能较好及病死率较低(11.6%vs28.3%,P<0.025).提示:AMI溶栓在国人使川链激酶、冰激酶可放宽至年龄起病至溶栓时间≤12小时,可使更多的忠者受益,安全而有效.
To investigate the effect of relaxing the AMI thrombolytic indications on the efficacy, safety and thrombolysis ratio.Methods: The main indications and curative effects of 201 patients who underwent thrombolytic therapy in 408 patients with AMI were observed. Results: (1) On the basis of the AMI economic suppository plan promoted by the editorial board of the Chinese Journal of Cardiology in 1991, the onset time from 6 hours to ≤12 hours was further relaxed, and the age ranged from ≤65 years (49.3%) were selected for thrombolysis compared with those without AMI (28.4%, P <0.001) and GISS1-2 (32.8%, P <0.001) (2) Thirty-two patients with AMI had an incidence of recanalization (62.5% vs 71.0%) and mortality (3.1%) after 6 hours and ≤12 hours compared with 169 patients ≤6 hours % Vs 6.5%, P> 0.05), which was significantly lower than that in insoluble group (18.4%, P <0.05); (3) 69 cases of AMI thrombolytic patients aged more than 65 years The heart function was better and the mortality rate was lower (11.6% vs28.3%, P <0.025) .This indicated that AMI thrombolytic therapy could ease the onset of thalassemia and ice-kinases to the onset of thrombolytic therapy≤12 Hours, can make more loyal benefit, safety Effect.