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为探讨静脉溶栓治疗对老年（６０岁以上）急性心肌梗塞（ＡＭＩ）患者近期预后的影响。方法对比分析２０例尿激酶静脉溶栓治疗与３８例非溶栓治疗的老年人ＡＭＩ患者住院期间临床疗效。结果显示溶栓组住院期间４周内病死率明显低于非溶栓组（Ｐ＜０．０５），且心绞痛、心力衰竭及严重心律失常、泵衰竭的发生率明显低于非溶栓组（Ｐ＜０．０５）。临床判断梗塞相关血管（ＩＲＡ）再通率为７５．０％（１５／２０），０～６小时ＩＲＡ再通率为８３．３％（１０／１２），６～１２小时为６２．５％（５／８），溶栓组无一例发生颅内出血及过敏反应。结论 提示用尿激酶静脉溶栓治疗老年ＡＭＩ为一种安全有效的方法，ＡＭＩ后梗塞相关血管及时有效再灌注有利于改善心肌梗塞的近期预后。
To explore the effect of intravenous thrombolysis on the short-term prognosis of elderly patients (aged 60 years and older) with acute myocardial infarction (AMI). Methods The clinical efficacy of 20 patients with AMI treated with intravenous thrombolytic therapy of urokinase and 38 patients without thrombolysis during their hospitalization were compared. The results showed that the mortality rate within 4 weeks of thrombolytic group was significantly lower than that of non-thrombolytic group (P <0.05), and the incidence of angina pectoris, heart failure and severe arrhythmia, pump failure was significantly lower than that of non-thrombolytic group P <0.05). The recanalization rate of IRA was 75.0% (15/20). The IRA recanalization rate was 83.3% (10/12) in 0-6 hours, 62.5% in 6-12 hours, (5/8). No intracranial hemorrhage and anaphylaxis occurred in the thrombolytic group. Conclusions These results suggest that intravenous thrombolytic therapy with urokinase is a safe and effective method for the treatment of AMI in elderly patients. AMI is effective in improving the short-term prognosis of myocardial infarction.