将７０例大于６５岁老年人急性心肌梗塞随机分成两组进行尿激酶疗效的对比研究。尿激酶溶栓组再通率４７１％，对照组再通率１３２％，两组有显著性差异（Ｐ＜００５）。虽然溶栓组住院病死率（２３５％）略低于对照组（２４５％），但两组相比无显著性差异（Ｐ＞００５）。本结果提示大于６５岁老年人急性心肌梗塞早期溶栓治疗虽可使冠脉再通，但对降低住院病死率的作用很小，这可能与溶栓组病例数较少有关。远期疗效有待于进一步随访观察。 A comparative study of 70 patients aged> 65 years with acute myocardial infarction randomized into two groups for the treatment of urokinase. The urokinase thrombolytic group recanalization rate was 471%, the control group recanalization rate was 132%, there was a significant difference between the two groups (P <005). Although the in-hospital mortality (23.5%) in the thrombolytic group was slightly lower than that in the control group (24.5%), there was no significant difference between the two groups (P> 0.05). The results suggest that early thrombolytic therapy in acute myocardial infarction in patients older than 65 years of age may lead to recanalization of the coronary artery but may have a small effect on reducing hospital mortality, which may be related to the small number of patients with thrombolytic therapy. Long-term efficacy needs further follow-up observation.