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目的总结高龄急性心肌梗死的临床特点。方法对2004年1月至2006年12月平庄煤业集团总公司医院18例高龄急性心肌梗死患者应用尿激酶溶栓治疗的临床资料进行回顾性分析。结果 18例患者溶栓治疗后,13例(72.22%)胸痛明显缓解,14例(77.78%)抬高的 ST 段回落≥50%,6例(33.33%)出现再灌注心律失常,10例(55.56%)心肌酶峰值提前。经临床综合判断12例患者梗死相关血管再通。2例(11.11%)出现皮肤黏膜出血,8例(44.44%)出现心律失常(包括6例再灌注心律失常),1例(5.56%)出现室颤,1例出现室间隔穿孔,4例(22.22%)出现左心功能衰竭,其中1例为心源性休克。结论溶栓治疗有利于挽救濒死心肌,保护心肌泵功能,提高早期存活率。尽早进行个体化溶栓,可降低高龄急性心肌梗死患者并发症,减少病死率。
Objective To summarize the clinical features of elderly acute myocardial infarction. Methods The clinical data of 18 cases of elderly patients with acute myocardial infarction treated with urokinase thrombolysis were retrospectively analyzed from January 2004 to December 2006 in Pingzhuang Coal Industry Group Corporation Hospital. Results Thirteen patients (72.22%) had relieved chest pain after thrombolysis in 18 patients. The ST-segment elevation in 14 patients (77.78%) dropped back to more than 50%, and 6 patients (33.33%) had reperfusion arrhythmia. 55.56%) myocardial enzyme peak early. The clinical diagnosis of 12 patients with infarct-related vascular recanalization. Skin mucosal hemorrhage occurred in 2 cases (11.11%), arrhythmia in 8 cases (including 6 cases of reperfusion arrhythmia), ventricular fibrillation in 1 case (5.56%), ventricular septal perforation in 1 case (4 cases) 22.22%) left heart failure, including 1 case of cardiogenic shock. Conclusion Thrombolytic therapy is beneficial to rescue dying myocardium, protect myocardial pump function and improve early survival rate. As soon as possible for individual thrombolysis, can reduce complications in elderly patients with acute myocardial infarction and reduce mortality.