有否静脉溶栓的急性心肌梗死63例尸解病理分析  

An autopsy pathological analysis of 63 cases with acute myocardial infarction with or without thrombolysis

作　　者：王冬梅[1] 韩雅玲[1] 佟铭[1] 宋福林[2] 荆全民[1] 苗志林[1] 王祖录[1] 王守力[1] 唐宜海 

机构地区：[1]沈阳军区总医院心内科,辽宁沈阳110015 [2]沈阳军区总医院病理科,辽宁沈阳110015

出　　处：《第四军医大学学报》2000年第1期64-65,共2页Journal of the Fourth Military Medical University

摘　　要：目的　探讨溶栓治疗的并发症 .方法　急性心肌梗死 (AMI)住院死亡并行尸体解剖 6 3例 ,2 6例曾给予溶栓治疗 ,37例行常规治疗 .结果　两组性别、年龄、CHD的危险因素 ,梗死次数 ,心肌酶学、梗死部位及血管狭窄程度均无明显差异 (P>0 .0 5 ) .但非溶栓组心肌出血明显高于溶栓组 ,而溶栓组心脏破裂明显高于非溶栓组 (P<0 .0 5 ) .结论　 AMI早期溶栓治疗心脏破裂的发生率较非溶栓组明显升高 .但其他并发症包括心肌出血 ,梗死面积扩展并不增加 ,心肌出血和心脏破裂多与血管狭窄的严重程度有关 .AIM To analyze complications of acute myocardial infarction with or without thrombolysis. METHODS 63 cases with acute myocardial infarction (AMI) were examined by autopsy, 26 of whom had undergone thromobolytic therapy and 37 routine treatment. RESULTS The two groups had no difference in sex, age, risk factors of CHD, times and sections of infarction, serum creatine kinase and the narrowing degree of vessels ( P >0.05). The myocardial hemorrhage in non thrombolysis group was much higher than that in thrombolysis group and the cardiac rupture in thrombolysis was also higher than that in non thrombolysis group ( P < 0.05 ). CONCLUSION Compared with AMI without thrombolysis, the incidence of cardiac rupture from AMI treated with thrombolysis is higher in the early stage, but not other complications such as single myocardial hemorrhage and infarction size expanding. The hemorrhage and cardiac rupture are associated with the severity of narrowing vessels.

关 键 词：AMI 心肌梗塞 静脉溶栓 尸体解剖 病理 

分 类 号：R542.220.2[医药卫生—心血管疾病]