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目的:探讨65岁以上急性心肌梗塞(AMI)患者接受静脉溶栓治疗的临床疗效及安全性.方法:收集2年内410例AMI患者中,203例接受静脉溶栓及其余未溶者临床资料.结果:①接受溶栓治疗的69例>65岁比134例≤65岁AMI患者,血管再通率(65.2%vs 70.9%)、住院期病死率(11.6%vs 4.5%)及轻度出血(20.3%vs 11.2%),均无显著差异(P均>0.05);②溶栓比不溶栓者的病死率下降幅度在>65岁明显高于≤65岁者(16.7%vs 5.9%,P<0.025);③51例≥75岁患者中,19例(37.3%)接受溶栓,其血管再通率63.2%.死亡明显低于未溶者5.3%vs31.3%,P<0.05),无脑出血等严重溶栓并发症.④>65岁比≤65岁者接受溶栓比未溶患者之间病死率差值明显缩小(17.9%vs 7.1%).结论:>65岁AMI接受静脉溶栓治疗安全有效,而且受益可能更大.
Objective: To investigate the clinical efficacy and safety of intravenous thrombolysis in patients with acute myocardial infarction (AMI) over 65 years old.Methods: Among 410 AMI patients in two years, 203 received intravenous thrombolysis and the remaining undissolved patients. Results: ① Thirty-nine patients undergoing thrombolysis compared with 134 patients aged ≤65 years undergoing revascularization (65.2% vs 70.9%), hospital stay mortality (11.6% vs 4.5%) and mild bleeding 20.3% vs 11.2%, respectively) (all P> 0.05). ② The reduction rate of mortality in patients with thrombolysis and non-thrombolysis was significantly higher than that in patients aged 65 or older than 65 (16.7% vs 5.9%, P <0.025); ③ Among the 51 patients ≥75 years of age, 19 (37.3%) received thrombolysis, the rate of vascular recanalization was 63.2%, the death rate was significantly lower than that of untreated patients (5.3% vs31.3%, P <0.05) Cerebral hemorrhage and other severe thrombolytic complications.④The mortality difference between patients under 65 and 65 years old who received thrombolytic therapy was significantly reduced (17.9% vs 7.1%). Conclusion: AMI> 65 years old received intravenous Suppositories are safe and effective and may benefit even more.