CAJ | 학술논문

目的观察尿激酶天普洛欣(UKTP)静脉溶栓治疗高龄急性心肌梗死(AMI)患者的临床有效性和安全性。方法 1994年1月至1999年2月我院急诊科收治的502例老年AMI患者，按年龄分为三组：≥70岁组(117例)，65～69岁组(152例)和65岁组(233例)，观察临床疗效，副作用及病死率等。UKTP剂量为200万U至300万U，采用Bolus法30 min内给药。结果 (1)按临床梗塞相关血管(IRA)再通标准，三组再通率依次为70.9%，79.6%和81.5%，≥70岁组与65岁组间比较，差异有显著性(P<0.05)。总再通率为78.5%。(2)5周病死率分别为3.4%，3.3%和3.0%，三组间差异无显著性(P均>0.05)。总病死率为3.2%。(3)轻度出血发生率三组分别为17.9%，16.4%和16.3%，组间亦差异无显著性(P均>0.05)，中度出血发生率为0.9%，0.7%和1.3%，三组间差异无显著性(P均>0.05)。无脑出血者。出血总发生率为17.7%。(4)≥70岁组和65岁～69岁组EF均显著降低(P<0.01，0.05)。结论对高龄AMI患者进行尿激酶静脉溶栓治疗是安全有效。
목적관찰뇨격매천보락흔(UKTP)정맥용전치료고령급성심기경사(AMI)환자적림상유효성화안전성。방법 1994년1월지1999년2월아원급진과수치적502례노년AMI환자，안년령분위삼조：≥70세조(117례)，65～69세조(152례)화65세조(233례)，관찰림상료효，부작용급병사솔등。UKTP제량위200만U지300만U，채용Bolus법30 min내급약。결과 (1)안림상경새상관혈관(IRA)재통표준，삼조재통솔의차위70.9%，79.6%화81.5%，≥70세조여65세조간비교，차이유현저성(P<0.05)。총재통솔위78.5%。(2)5주병사솔분별위3.4%，3.3%화3.0%，삼조간차이무현저성(P균>0.05)。총병사솔위3.2%。(3)경도출혈발생솔삼조분별위17.9%，16.4%화16.3%，조간역차이무현저성(P균>0.05)，중도출혈발생솔위0.9%，0.7%화1.3%，삼조간차이무현저성(P균>0.05)。무뇌출혈자。출혈총발생솔위17.7%。(4)≥70세조화65세～69세조EF균현저강저(P<0.01，0.05)。결론대고령AMI환자진행뇨격매정맥용전치료시안전유효。
Objective　To observe the clinical efficacy and safety of intravenous thrombolytic therapy using Urokinase Techpool (UKTP) in elderly patients with acute myocardial infarction (AMI).Methods　Five hundredn and two patients with AMI were treated with UKTP during January 1994 to February 1999, and divided into three groups: ≥70 years (117), 65 years-69 years (152) and <65 years (233). The clinic therapeutic efficacy, Side effects and mortality were analyzed in aged patients with AMI treated with UKTP 2 million U to 3 million U intravenous infusion within 30 minutes according to Bolus method. Results　(1) The reperfusion rate in infarct——related artery (IRA) by clinic standards in ≥70 group vears was 70.9%, stinificantly lower that of 502 cases was 78.5%. (2) The mortality in first five weeks in ≥70 years group was 3.4%, in 65 years to 69 years group was 3.3% and in <65 years group was 3.0% (all P>0.05). The total mortality was 3.2%. (3) The rate of bleeding was 17.9%, 16.4% and 16.3% mild bleeding was 0.9%, and 1.3% and 1.3% (P>0.05). The total rate of severe bleeding was 17.7% without intracranial hemorrhage. (4) EF respectively was 44.1±8.6, 46.2±6.6, 50.6±4.9 in three groups. In comparision of <65 years group, that of ≥70 years group and 65 years to 69 years group was respectively singificant (P<0.01, 0.05). Conclusion　The thromblytic therapy with UKTP is effective, and safe for aged patients with AMI.