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目的 探讨老年急性心肌梗死患者静脉溶栓的近期疗效。方法 对符合静脉溶栓治疗适应症、禁忌症除外的 2 6 6例急性心肌梗死患者进行治疗 ,非老年组 (A组 ) 111例 ,年龄 <6 0岁 ;老年组 (B组 ) 110例 ,年龄 6 0～ 6 9岁 ;高龄组 (C组 ) 45例 ,年龄≥ 70岁。三组同时给予国产尿激酶静脉溶栓治疗。结果 随年龄的增加冠状动脉梗死相关血管再通率逐渐下降 ,病死率升高。高龄组血WBC、静脉血糖 (BS)、肌酸激酶均显著高于其它两组 (P <0 .0 1、<0 .0 5 ) ;三组合并症除恶性室性心律失常 (室速 /室颤 ,VT/VF)、房室传导阻滞 (包括 :Ⅱ ,Ⅲ度A VB)无显著性差异 (P >0 .0 5 )外 ,高龄组合并症明显高于A、B两组 ,尤以出血 (包括皮肤、消化道、呼吸道、泌尿道和脑出血 )、心脏破裂及肺感染最显著 (P <0 .0 1) ,其次为泵衰竭 (心力衰竭 /心源性休克 ) (P <0 .0 5 )。结论 静脉溶栓治疗AMI对老年及高龄AMI患者有效 ,但并发症相对较多
Objective To investigate the short-term effect of intravenous thrombolysis in elderly patients with acute myocardial infarction. Methods One hundred and sixty-six patients with acute myocardial infarction who were eligible for intravenous thrombolytic therapy and other contraindications were treated. 111 cases (aged <60 years) in the non-elderly group (group A), 110 cases in the elderly group (group B) Age 6 0 ~ 6 9 years; 45 years old group (C group), age ≥ 70 years. Three groups given domestic urokinase intravenous thrombolytic therapy. Results With age, the rate of revascularization of coronary artery infarction gradually decreased and the mortality rate increased. Blood WBC, BS and creatine kinase in the elderly group were significantly higher than the other two groups (P <0.01, <0.05); three groups of complications in addition to malignant ventricular arrhythmia (VT / VF, VT / VF), atrioventricular block (including: Ⅱ, Ⅲ degree A VB) was no significant difference (P> 0.05) , Especially bleeding (including skin, digestive tract, respiratory tract, urinary tract and intracerebral hemorrhage), heart rupture and lung infection (P <0.01), followed by pump failure (heart failure / cardiogenic shock) ( P <0. 05). Conclusion Intravenous thrombolytic therapy of AMI is effective in elderly and elderly patients with AMI, but the complication is relatively high