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目的 :探讨重组组织型纤溶酶原激活剂 (rt PA)静脉溶栓治疗急性心肌梗死 (AMI)的疗效及安全性。方法 :选择 2 0例AMI患者应用rt PA静脉溶栓治疗 ,观察临床症状、心电图、心肌酶谱的变化 ,判断冠状动脉再通率。结果 :① 2 0例AMI患者 ,冠状动脉再通 12例 ,再通率 6 0 %,其中发病 6h以内溶栓再通率 87.5 %(7/ 8) ,发病 6～ 2 4h溶栓再通率 4 1.7%(5 / 12 ) ,两者相比差异有显著性意义 (P <0 .0 5 )。②≤ 6 5岁患者的血管再通率与不良反应发生率与 >6 5岁组相比差异无显著性意义 (P >0 .0 5 )。结论 :rt PA静脉溶栓治疗AMI是一种安全、有效的方法 ,宜提倡急诊室溶栓。 >6 5岁患者行静脉溶栓治疗是安全可行的 ,但要根据患者的具体情况而定。
Objective: To investigate the efficacy and safety of intravenous thrombolysis with recombinant tissue plasminogen activator (rt PA) in the treatment of acute myocardial infarction (AMI). Methods: Twenty patients with AMI were enrolled in this study. Rt PA thrombolytic therapy was used to observe the changes of clinical symptoms, electrocardiogram and myocardial enzymes, and determine the rate of coronary recanalization. RESULTS: Twenty patients with AMI had recanalization of the coronary artery in 12 cases and the recanalization rate was 60%. The recanalization rate of the thrombolysis within 6 hours after onset of the disease was 87.5% (7/8), and the recurrence rate of thrombolysis was 6 to 24 hours 4 1.7% (5/12), there was significant difference between the two (P <0.05). The incidence of recanalization and adverse reactions in patients younger than or equal to 65 years was not significantly different from that of patients aged> 65 years (P> 0.05). Conclusion: rt PA intravenous thrombolytic therapy of AMI is a safe and effective method, it is appropriate to promote emergency department thrombolysis. > 6-year-old patients undergoing intravenous thrombolysis is safe and feasible, but according to the specific circumstances of patients.