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目的:探讨小剂量(50 mg)重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓治疗老年急性心肌梗死(AMI)的疗效及安全性。方法:老年AMI患者57例,90分钟内静脉注射rt-PA 50mg,依据临床指标判断再通与否。应用超声心动图比较再通组与未通组的心功能。结果:冠脉再通率71.9%(41/57),再通组心功能明显好于未通组(P<0.01),5周病死率再通组2.4%显著低于未通组(12.5%)(P<0.001)。住院期间再梗死率7.0%(4/57),出血发生率14.0%(8/57)。结论:小剂量rt-PA静脉溶栓可获较高冠脉再通率,明显改善心功能,降低病死率、出血并发症及医疗费用。
Objective: To investigate the efficacy and safety of intravenous thrombolytic therapy of low dose (50 mg) recombinant tissue plasminogen activator (rt-PA) in elderly patients with acute myocardial infarction (AMI). Methods: 57 elderly AMI patients were given rt-PA 50 mg intravenously in 90 minutes. The recanalization was judged according to clinical indexes. Echocardiography was used to compare the cardiac function between the recanalization group and the failed group. Results: The rate of coronary recanalization was 71.9% (41/57), and the cardiac function of the recanalization group was significantly better than that of the control group (P <0.01). The 5-week mortality rate of recanalization group was significantly lower than that of the control group (12.5% ) (P <0.001). The rate of reinfarction in hospital was 7.0% (4/57) and the incidence of bleeding was 14.0% (8/57). Conclusion: The low dose rt-PA intravenous thrombolysis can be higher recanalization rate, significantly improve cardiac function, reduce mortality, bleeding complications and medical costs.