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目的 :探讨溶栓治疗对急性心肌梗死 ( AMI)患者急性期和远期预后的影响。方法 :将14 3例 AMI患者分为溶栓再通组 ( 35例 )、未通组 ( 2 3例 )和对照组 ( 85例 ) ,比较急性期和远期预后。结果 :急性期心脏性死亡率再通组 ( 2 .9% )、未通组 ( 13.0 % )明显低于对照组 ( 2 5 .9% ) ;其它心脏事件发生率、左室功能及运动耐量比较 ,再通组均明显优于其他两组 ,而未通组大多数指标亦优于对照组 ( P <0 .0 5～ 0 .0 1)。远期随访 ,再通组、未通组 3年生存率分别为 94.3%和 82 .6% ,明显高于对照组 ( 71.8% ) ( P <0 .0 5～ 0 .0 1) ;但心绞痛、再梗、左室功能及运动耐量三组间无显著性差异( P >0 .0 5 )。结论 :溶栓治疗能显著改善 AMI患者急性期预后 ,即使临床间接指征判定未通者 ,其部分指标亦优于对照组。溶栓治疗能提高 AMI患者 3年生存率 ,但对远期再梗、心绞痛、左室功能及运动耐量改善不明显。
Objective: To investigate the effect of thrombolytic therapy on the acute and long-term prognosis of patients with acute myocardial infarction (AMI). Methods: A total of 143 AMI patients were divided into thrombolytic group (35 cases), unreasonable group (23 cases) and control group (85 cases). The acute and long-term prognosis were compared. Results: The rates of cardiac events, left ventricular function and exercise tolerance in acute recurrent cardiac death group (2.9%) and unreasonable group (13.0%) were significantly lower than those in control group (25.9% Comparison, recanalization group were significantly better than the other two groups, and most of the indicators are not better than the control group (P <0.05 ~ 0. 01). The long-term follow-up, 3-year survival rates of the recanalization group and the failed group were 94.3% and 82.6%, respectively, which were significantly higher than those in the control group (71.8%) (P <0.05-0.01) , Restenosis, left ventricular function and exercise tolerance were not significantly different among the three groups (P> 0.05). Conclusion: Thrombolytic therapy can significantly improve the prognosis of AMI patients in acute stage, even if the clinical indirect indications failed to pass, some of its indicators are also superior to the control group. Thrombolytic therapy can improve the 3-year survival rate of patients with AMI, but the long-term restenosis, angina, left ventricular function and exercise tolerance did not improve significantly.