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目的 尝试用小剂量尿激酶治疗老年高龄急性心肌梗死 ,旨在使老年高龄患者亦从溶栓治疗中获益。方法 采用WHO关于急性心肌梗死 (AMI)的诊断标准 ,收治老年高龄患者 6 5例。随机分为两组 ,溶栓组 31例 ,给予小剂量尿激酶 (5 0×10 4U) 30min静脉滴入 ;并与非溶栓组 34例对照观察。结果 溶栓组冠脉再通率、五周病死率、休克、心衰分别为 5 4 .8%、6 4 %、3.2 %、9.7% ;而对照组分别为 14 .7%、2 3.5 %、2 6 .5 % :4 1.2 % ,有明显差异 (P <0 .0 1)。结论 有条件的基层医院依然有可能实施小剂量尿激酶对老年高龄患者的溶栓治疗 ,且可挽救更多老年高龄患者的生命。
Aims Attempting to treat elderly elderly patients with acute myocardial infarction with low-dose urokinase is intended to benefit elderly patients with thrombolysis as well. Methods According to WHO diagnostic criteria of acute myocardial infarction (AMI), 65 cases of elderly patients were admitted. Thirty-seven patients were randomly divided into two groups: thrombolytic group (n = 31) and low-dose urokinase (n = 50) administered intravenously for 30min. Results The rate of coronary recanalization, five-week mortality, shock and heart failure in the thrombolysis group were 54.8%, 64%, 3.2% and 9.7% respectively, while those in the control group were 14.7% and 23.5% , 26.5%: 4 1.2%, there was a significant difference (P <0.01). CONCLUSIONS It is still possible for grassroots hospitals with conditions to implement thrombolysis in elderly patients with low-dose urokinase and to save lives for more elderly patients.