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目的 :观察 70岁以上老年急性心肌梗死 (AMI)的静脉溶栓疗效。方法 :35例 70岁以上 AMI患者(病例组 )采用尿激酶静脉溶栓 ,与同期 42例≤ 6 9岁的 AMI患者作对照。观察患者末梢血嗜酸粒细胞计数及血液皮质醇含量 ,比较 2组再通率及溶栓后并发症发生率。结果 :老年 AMI患者末梢血嗜酸粒细胞计数减少 ,血皮质醇升高。 2组患者 49小时以上溶栓者 5例 ,无一例再通。 2组 12小时内溶栓再通率无明显差异 ,溶栓后并发症发生率无显著性差异。结论 :对老年 AMI患者静脉溶栓仍是安全有效的治疗方法 ;年龄不是静脉溶栓疗法的严格限制因素 ;AMI静脉溶栓的时间窗可以限制在 36小时以内
Objective: To observe the effect of intravenous thrombolysis in elderly patients with acute myocardial infarction (AMI) over 70 years old. Methods: Thirty-five AMI patients over 70 years old (case group) received intravenous thrombolysis of urokinase, which were compared with 42 AMI patients aged <69 years. The peripheral blood eosinophil count and blood cortisol level were observed. The recanalization rate and complication rate after thrombolysis were compared between the two groups. Results: Elderly AMI patients with peripheral blood eosinophil count decreased, blood cortisol increased. There were 5 cases of thrombolysis in more than 49 hours in 2 groups, none of them recanalized. There was no significant difference in the rate of thrombolysis within 12 hours in 2 groups, no significant difference in the incidence of complications after thrombolysis. Conclusions: Intravenous thrombolysis is still a safe and effective treatment for elderly patients with AMI; age is not a severe limitation for intravenous thrombolytic therapy; and the time window for intravenous thrombolysis in AMI can be limited to within 36 hours