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目的探讨静脉溶栓治疗急性右室心肌梗塞之临床疗效及安全性。方法连续选择4年内649例AMI患者中，67例右室AMI（均合并下、后壁心肌梗塞）患者诊治资料，进行各亚组疗效比较。结果（1）67例右室AMI患者中，42例接受溶栓治疗，高于平均接受率（62．7％比46．1％，P＜0．01）。（2）未接受溶栓治疗之患者中，右室AMI在住院期病死率（28．0％比13．6％）、右心衰合并左心功能不全≥KillipⅢ级（60％比32．6％）及恶性心律失常发生率（44％比21．8％）均比非右室AMI患者明显为高（P＜0．05～0．01）。（3）右室AMI患者比非右室组，在溶栓后的病死率（-20．9％比-7．4％）、心功能≥Ⅲ级（-31．4％比-19．0％）及严重心律失常发生率（-25．0％比-11．7％）的净减少率均更为显著（P＜0．05～0．01）。结论右室AMI患者接受静脉溶栓治疗安全、有效，并比非右室AMI患者得益更大。
Objective To investigate the clinical efficacy and safety of intravenous thrombolysis in the treatment of acute right ventricular myocardial infarction. Methods A total of 649 patients with AMI were enrolled in this study. Sixty-seven patients with right ventricular AMI (all combined with posterior wall myocardial infarction) were selected for follow-up. The curative effect of each subgroup was compared. Results (1) Of 67 patients with right ventricular AMI, 42 received thrombolysis, which was higher than the average accepted rate (62.7% vs 46.1%, P <0.01). (2) Among the patients who did not receive thrombolytic therapy, the mortality rate of right ventricular AMI during hospitalization (28.0% vs. 13.6%), right heart failure with left ventricular dysfunction≥KillipⅢ (60% vs 32.6 %) And malignant arrhythmia (44% vs. 21.8%) were significantly higher than those in non-right ventricular AMI patients (P <0.05-0.01). (3) The mortality of right ventricular AMI patients after thrombolysis was higher than that of non-right ventricular group (-20.9% vs -7.4%), and heart function≥Ⅲ (-31.4% vs -19.0 %) And the incidence of severe arrhythmia (-25.0% vs -11.7%) were significantly more significant (P <0.05-0.01). Conclusion Intravenous thrombolysis in patients with right ventricular AMI is safe, effective and more beneficial than non-right ventricular AMI patients.