静脉溶栓时机对ST段抬高型心肌梗死患者临床疗效及预后的影响  

Influence of timing of intravenous thrombolysis on clinical efficacy and prognosis in patients with STsegment elevation myocardial infarction

作　　者：何华斌[1] HE Huabin(Department of Cardiovascular Medicine,First People's Hospital of Jiujiang,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第一人民医院心血管内科,江西九江332000

出　　处：《当代医学》2022年第26期113-116,共4页Contemporary Medicine

摘　　要：目的分析静脉溶栓时机对ST段抬高型心肌梗死(STEMI)患者临床疗效及预后的影响。方法回顾性分析2018年7月至2019年12月本院收治的60例STEMI患者的临床资料,根据溶栓治疗的时间不同分为A组(发病至溶栓治疗时间<6 h,n=22)、B组(发病至溶栓治疗时间6~12 h,n=20)、C组(发病至溶栓治疗时间>12 h,n=18)。比较3组溶栓效果、ST段回落情况及住院期间不良心血管事件发生情况。结果3组溶栓再通率比较差异有统计学意义(P<0.05);A组溶栓再通率明显高于B组、C组,差异有统计学意义(P<0.05)。3组溶栓治疗后ST段回落幅度、回落所需时间比较差异有统计学意义(P<0.05);A组、B组治疗后ST段回落幅度均明显大于C组,回落所需时间均明显短于C组,且A组治疗后ST段回落幅度大于B组,回落所需时间短于B组,差异有统计学意义(P<0.05)。A组不良心血管事件发生率明显低于B组、C组,差异有统计学意义(P<0.05)。结论STEMI患者早期行静脉溶栓治疗效果较好,可提高ST段回落幅度,缩短ST段回落时间,降低不良心血管事件发生率,值得临床推广应用。Objective To analyze the influence of timing of intravenous thrombolysis on the clinical efficacy and prognosis of patients with STdoi:segment elevation myocardial infarction(STEMI).Methods The clinical data of 60 patients with STEMI admitted to our hospital from July 2018 to December 2019 were retrospectively analyzed,and they were divided into group A(time from onset to thrombolytic therapy<6 h,n=22),group B(time from onset to thrombolytic therapy 6-12 h,n=20),group C(time from onset to thrombolytic therapy>12 h,n=18).The thrombolytic effect,STsegment fall and adverse cardiovascular events during hospitalization were compared among the three groups.Results There was statistically significant difference in the thrombolytic recurrence rate among the three groups(P<0.05);the thrombolytic recurrence rate of group A was significantly higher than that of group B and group C,and the difference was statistically significant(P<0.05).There were significant differences in the ST-segment fall back and the time required for ST-segment fall after thrombolytic therapy among the three groups(P<0.05).The ST-segment fall after thrombolytic therapy in group A and group B was significantly greater than that in group C,and the time required for ST-segment fall was significantly shorter than that in group C,and the ST-segment fall after thrombolytic therapy in group A was significantly greater than that in group B,the time required for ST-segment fall in group A was significantly shorter than that in group B,and the difference was statistically significant(P<0.05).The incidence of adverse cardiovascular events in group A was significantly lower than that in group B and group C,and the difference was statistically significant(P<0.05).Conclusion Early intravenous thrombolysis in patients STEMI with has better effect,which can increase the ST-segment fall,shorten the ST-segment fall time,and reduce the incidence of adverse cardiovascular events,which is worthy of clinical application.

关 键 词：静脉溶栓 ST段抬高型心肌梗死 溶栓效果 预后 

分 类 号：R542.22[医药卫生—心血管疾病]