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目的:观察老年高龄急性心肌梗死尿激酶静脉溶栓治疗的疗效及安全性。方法:对我院2000年1月至2009年12月以来收治的年龄>75岁的老年急性ST段抬高心肌梗死患者,静脉尿激酶溶栓疗效及安全性进行回顾性分析。共56例,其中男性33例,女性23例,年龄75岁～82岁,平均年龄78.62岁,全部病例均符合WHO规定的AMI诊断标准,治疗均给予尿激酶100U～125万U,加生理盐水100ml,静脉点滴,30min滴完。结果:56例患者52例痊愈出院,4例死亡。其中41例溶栓成功,再通率达73.21%;1例脑出血,3例泌尿系出血,2例咳血;发生再灌注心律失常12例;心衰6例。结论:本研究观察证实尿激酶静脉溶栓疗法,在老年高龄患者中,可降低老年高龄AMI病死率、减少并发症,改善心功能,改善预后,具有较高安全性。
Objective: To observe the efficacy and safety of intravenous thrombolysis with urokinase in elderly patients with acute myocardial infarction. Methods: A retrospective analysis was performed on the efficacy and safety of intravenous urokinase thrombolysis in elderly patients with acute ST-segment elevation myocardial infarction who were admitted to our hospital from January 2000 to December 2009. A total of 56 cases, including 33 males and 23 females, aged 75 years to 82 years, mean age 78.62 years, all cases were in line with WHO diagnostic criteria for AMI, were given urokinase 100U ~ 1.25 million U, plus saline 100ml, intravenous drip, 30min drip finished. Results: Fifty-two patients in 56 cases were discharged and 4 patients died. Among them, 41 cases were succeeded in thrombolysis, and the recanalization rate reached 73.21%. One case had cerebral hemorrhage, three cases had urinary hemorrhage and two cases had hemoptysis. There were 12 cases of reperfusion arrhythmia and 6 cases of heart failure. Conclusion: This study confirmed that intravenous thrombolytic therapy of urokinase in elderly patients, can reduce the elderly AMI mortality, reduce complications, improve cardiac function, improve prognosis, with high safety.