目的探讨高龄(≥75岁)急性心肌梗塞患者静脉溶栓的疗效及安全性。方法将62例高龄急性心肌梗死患者随机分为溶栓组和常规治疗组。溶栓组32例,采用尿激酶静脉溶栓加皮下注射小剂量低分子肝素钙。常规治疗组30例,除不用尿激酶及小剂量低分子肝素钙外,其余治疗均与溶栓组相同。结果冠状动脉再通率溶栓组为65.6%(21/32),常规治疗组为16.7%(5/30),两组比较差异具有显著性(P<0.05)。溶栓组病死率为6.3%(2/32),而常规治疗组病死率为23.3%(7/30),两组比较具有显著差异性(P<0.05)。两组无严重出血并发症,出血并发症比较差异无显著性(P>0.05)。结论尿激酶静脉溶栓治疗高龄急性心肌梗死可以提高冠状动脉再通率,降低死亡率和改善预后,是可行性治疗措施。 Objective To investigate the efficacy and safety of intravenous thrombolysis in elderly (≥75 years) patients with acute myocardial infarction. Methods 62 cases of elderly patients with acute myocardial infarction were randomly divided into thrombolytic group and conventional treatment group. Thrombolytic group of 32 cases, the use of urokinase intravenous thrombolysis and subcutaneous injection of low-dose low molecular weight heparin. 30 cases of conventional treatment group, except without urokinase and low-dose low molecular weight heparin, the rest of the treatment and thrombolytic group. Results The rate of coronary recanalization was 65.6% (21/32) in the thrombolytic group and 16.7% (5/30) in the conventional treatment group. There was significant difference between the two groups (P <0.05). The case fatality rate was 6.3% (2/32) in the thrombolytic group, and 23.3% (7/30) in the conventional treatment group. There was significant difference between the two groups (P <0.05). There was no significant difference in bleeding complications between the two groups (P> 0.05). Conclusion Urokinase intravenous thrombolysis in elderly patients with acute myocardial infarction can improve the rate of coronary recanalization, reduce mortality and improve prognosis, is a feasible treatment.