静脉溶栓治疗对急性心肌梗塞远期预后的影响  

Effect of intravenous thrombolytic treatment on long term prognosis of patients with acute myocardial infarction/

作　　者：石燕[1] 洪和秀[1] 钟蓓 

机构地区：[1]北京市第六医院

出　　处：《中国危重病急救医学》1997年第6期348-351,共4页Chinese Critical Care Medicine

摘　　要：目的：观察静脉溶栓治疗对急性心肌梗塞（ＡＭＩ）患者远期预后的影响。方法：采用超声心动图、２４小时动态心电图、心电图运动试验及心室晚电位检查，对９４例接受溶栓治疗的ＡＭＩ患者进行６个月～３年的随访。结果：在６个月～３年的随访中，前壁再通组左房内径（ＬＡＤ）、左室舒张末内径（ＬＶＥＤ）和左室射血分数（ＬＶＥＦ）均明显短于前壁未通组（Ｐ均＜０．０５）；而下壁再通组与未通组ＬＡＤ、ＬＶＥＤ和ＬＶＥＦ无明显差别。再通组各种心律失常的发生率明显低于未通组，再通组的运动耐量明显高于未通组（Ｐ均＜０．０５）。结论：静脉溶栓对改善前壁心肌梗塞患者远期心功能疗效显著，对下壁心肌梗塞患者心功能改善不明显；但静脉溶栓对前壁或下壁心肌梗塞患者，在减少远期心律失常的发生，增强运动耐量和提高生活质量方面均有着重要意义。Objective:To observe the effect of intravenous thrombolytic treatment on acute myocardial infarction(AMI).Methods:94 cases of AMI were examinated with ultrasonic cardiography (UCG),Holter,ECG sporting test and ventricular late potential.Otherwise,followup were taken for six months to three years.Results:The parameters of left atrial dimension(LAD),left ventricular end diastolic dimension (LVED) and left ventricular ejection fraction (LVEF) in anterior wall repass group are superior to non re pass group ,but they were no improved significantly in inferior wall repass and occlusive group.On the other hand,the morbidity of arrhythmia was decreased significantly in repass group,while it not in no repass group ( P <0 05) and movement tolerance was improved significantly in repass group, compared with no repass group ( P <0 05).Conclusions:These datum showed that intravenous thrombolytic treatment could be improving the longterm cardiac function of patients with anterior wall infarct,but not in patients with inferior wall infarct.While it could be decreasing morbidity of arrhythmia,enhancing movement tolerance and improving life quality for both anterior wall and inferior wall infarct patients.

关 键 词：心肌梗塞 急性 溶栓治疗 心功能 

分 类 号：R542.220.5[医药卫生—心血管疾病]