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急性心肌梗塞(AMI)患者并发中风,在溶栓疗法问世之前,多为脑梗塞。自溶栓疗法应用以来,出血性中风是否有所增加?此研究目的是(1)了解大系列行溶栓治疗的AMI 患者出血及非出血性中风的发病率;(2)检查两者的临床关系和近期及远期预后。方法病例均系“心肌梗塞溶栓及冠脉成形术”(TAMI)Ⅰ、Ⅱ、Ⅲ期试验登记的患者共708例,已除外年龄>75岁,心原性休克,并存晚期癌肿以及存在出血潜在危险因素者,均在起病后1～3小时内开始用静脉溶栓。Ⅰ期试验患者单用组织型纤溶酶激活剂(rt-PA)先给负荷量,后渐减量,5小时内总
Patients with acute myocardial infarction (AMI) complicated by stroke are mostly cerebral infarcts before thrombolytic therapy is available. Whether hemorrhagic stroke has increased since thrombolytic therapy? The purpose of this study was to (1) understand the incidence of bleeding and non-hemorrhagic stroke in a large series of thrombolytic patients with AMI, and (2) examine both clinical Relationship and recent and long-term prognosis. Methods A total of 708 cases were enrolled in stage I, II, and III trials of myocardial infarction and thrombolysis and coronary angioplasty (TAMI). Excluded patients were 75 years of age, cardiogenic shock, coexisting with advanced cancer and their presence Bleeding potential risk factors, all within 1 to 3 hours after onset began to use intravenous thrombolysis. Patients in stage I trial were given tissue-type plasminogen activator (rt-PA) first to load, after gradual decrease in 5 hours total