心脏杂志
心髒雜誌
심장잡지
CHINESE HEART JOURNAL
2001年
1期
27-29
,共3页
李成祥%王爽%宁亚兰%李伟杰%张玉顺%王海昌%张清%栾荣华%张殿新%郭文怡%贾国良
李成祥%王爽%寧亞蘭%李偉傑%張玉順%王海昌%張清%欒榮華%張殿新%郭文怡%賈國良
리성상%왕상%저아란%리위걸%장옥순%왕해창%장청%란영화%장전신%곽문이%가국량
心肌梗塞,急性%溶血栓疗法
心肌梗塞,急性%溶血栓療法
심기경새,급성%용혈전요법
目的：调查初发急性心肌梗死（AMI）溶栓疗法的应用现状及近期疗效。方法：总结我院1996-01～1999-08期间所有确诊初发AMI患者的临床资料，发病超过24 h入院、外院转来、心内膜下心梗、再梗患者除外。结果：202例初发AMI患者中，148例 (73.3%) 符合溶栓适应证，132例（65.3%）应用溶栓疗法，36例（24.3%）未溶栓（16例）或溶栓药物剂量不足（20例）。70例未溶栓患者中，发病—入院>12 h、符合适应证而未予溶栓、溶栓禁忌、入院心电图不能确诊AMI的比例分别为60.0%，22.8%，8.6%和8.6%。溶栓组住院期间病死率显著低于未溶栓组（6.1% vs 15.7%，P<0.05），其中再通组病死率显著低于未通组（2.3% vs 20.8%，P<0.01）。结论：尽管溶栓疗法改善了AMI的近期预后，但合理应用溶栓疗法的比例仍有待提高，患者入院过迟、溶栓治疗不积极是溶栓疗法应用偏低的主要原因。
目的：調查初髮急性心肌梗死（AMI）溶栓療法的應用現狀及近期療效。方法：總結我院1996-01～1999-08期間所有確診初髮AMI患者的臨床資料，髮病超過24 h入院、外院轉來、心內膜下心梗、再梗患者除外。結果：202例初髮AMI患者中，148例 (73.3%) 符閤溶栓適應證，132例（65.3%）應用溶栓療法，36例（24.3%）未溶栓（16例）或溶栓藥物劑量不足（20例）。70例未溶栓患者中，髮病—入院>12 h、符閤適應證而未予溶栓、溶栓禁忌、入院心電圖不能確診AMI的比例分彆為60.0%，22.8%，8.6%和8.6%。溶栓組住院期間病死率顯著低于未溶栓組（6.1% vs 15.7%，P<0.05），其中再通組病死率顯著低于未通組（2.3% vs 20.8%，P<0.01）。結論：儘管溶栓療法改善瞭AMI的近期預後，但閤理應用溶栓療法的比例仍有待提高，患者入院過遲、溶栓治療不積極是溶栓療法應用偏低的主要原因。
목적：조사초발급성심기경사（AMI）용전요법적응용현상급근기료효。방법：총결아원1996-01～1999-08기간소유학진초발AMI환자적림상자료，발병초과24 h입원、외원전래、심내막하심경、재경환자제외。결과：202례초발AMI환자중，148례 (73.3%) 부합용전괄응증，132례（65.3%）응용용전요법，36례（24.3%）미용전（16례）혹용전약물제량불족（20례）。70례미용전환자중，발병—입원>12 h、부합괄응증이미여용전、용전금기、입원심전도불능학진AMI적비례분별위60.0%，22.8%，8.6%화8.6%。용전조주원기간병사솔현저저우미용전조（6.1% vs 15.7%，P<0.05），기중재통조병사솔현저저우미통조（2.3% vs 20.8%，P<0.01）。결론：진관용전요법개선료AMI적근기예후，단합리응용용전요법적비례잉유대제고，환자입원과지、용전치료불적겁시용전요법응용편저적주요원인。
AIM： To survey the use of thrombolytic therapy (TT) for first acute myocardial infarction (AMI) in recent years. METHODS Data from patients with confirmed first AMI were collected in a single center during 1996 through 1999. The exclusion criteria include: the interval from symptom onset to presentation >24 h, transferred from other hospitals, subendocardial MI, and reinfarction. RESULTS:Among 202 patients enrolled , 132(65.3%) of 148(73.3%) patients eligible for TT received TT, 36(24.3%) received insufficient dosage of thrombolytic agents (20) or even no TT (16). Among 70 untreated patients, the elapsed time from symptom onset to presentation >12 h, eligible but withholding from TT, contraindications, undiagnostic ECG were found in 22.8%, 60.0%, 8.6% and 8.6%, respectively. The inhospital mortality of patients treated with TT was significantly lower than in counterpart patients (6.1% vs 15.7%, P<0.05) . Of patients treated with TT, the mortality in the reperfusion subgroup was lower than in the counterpart subgroup(2.3% vs 20.8%,P<0.01) . CONCLUSION:Although TT improve the short-term prognosis for first AMI, it was still underused in recent years. The late arrival of the patients and unaggressive attitude of attending physicians toward TT mainly explain this status.
