摘要
目的：观察ST段抬高心肌梗死（STEMI）患者溶栓治疗时机与预后的关系。方法纳入2008年7月~2012年6月广东省吴川市人民医院STEMI患者229例，所有患者均采用溶栓治疗。根据患者发病至溶栓时间，分为4个治疗时间段，发病至溶栓＜3h为第1组（n=67），（3～6）h为第2组（n=96），（6～12）h为第3组（n=45），（12～24）h为第4组（n=21）。观察各组溶栓再通率（包括胸痛缓解、心电图ST段回落和心肌酶CK-MB峰值提前）以及30天内全因死亡率。结果随着发病至溶栓时间的延长，溶栓再通率不断下降[第1组：82.09%（55/67），第2组：73.96%（71/96），第3组：42.22%（19/45），第4组：35.00%（7/20）]，30天死亡率不断升高[第1组：5.97%（4/67）；第2组：9.38%（9/96）；第3组：11.11%（5/45），第4组：15.00%（3/20）]，各组之间均有统计学差异（P＜0.05）。结论溶栓治疗时机越早则患者预后越好，超过12小时的患者仍可进行溶栓治疗，并能够改善预后。
Objective To observe the relationship between opportunity and prognosis of thrombolytic treatment of ST-segment elevation myocardial infarction （STEMI）.Methods The patients diagnosed as STEMI （n=229） were chosen from People’s Hospital of Wuchuan City of Guangdong Province from Jul. 2008 to Jun. 2012. All patients were given thrombolytic treatment, and the treatment time was divided into 4 groups according to the periods from disease onset time to thrombolytic time. The period less than 3 h was taken as group 1 （n=67）, （3-6） h as group 2 （n=96）, （6-12） h as group 3 （n=45） and （12-24） h as group 4 （n=21）. The recanalization rate （including chest pain relieving, ST-segment falling back and peak of myocardial enzyme CK-MB advancing） and all-cause mortality within 30 d were observed in all groups.Results As the prolong of the periods from disease onset time to thrombolytic time, recanalization rate decreased continuously [group 1： 82.09% （55/67）, group 2： 73.96% （71/96）, group 3： 42.22% （19/45） and group 4： 35.00% （7/20）], and all-cause mortality within 30 d increased continuously [group 1： 5.97% （4/67）, group 2： 9.38% （9/96）, group 3： 11.11% （5/45） and group 4： 15.00% （3/20）]. There was statistical difference among all groups （P〈0.05）.Conclusion If the time of thrombolytic treatment is earlier, the prognosis will be better in the patients with STEMI. The patients with disease onset time over 12 h still can be given thrombolytic treatment and the prognosis can be improved.
出处
《中国循证心血管医学杂志》
2013年第6期608-610,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
ST段抬高型心肌梗死
时机
溶栓治疗
临床疗效
预后
ST-segment elevation myocardial infarction
Opportunity
Thrombolytic treatment
Curative effect
Prognosis
