目的 :研究急性心肌梗死 (AMI)发病后不同时间溶栓治疗对血管再通的影响。方法 :1 69例 >70岁老年人 AMI静脉溶栓治疗患者 ,根据发病后不同时间溶栓分为≤ 2 h,>2～ 4h,>4～ 6h,>6～ 1 2 h和 >1 2～ 2 4 h5组。结果 :5组血管再通率分别为 80 .8%、75.6%、71 .0 %、47.6%和 46.2 % ,前 3组与后 2组间比较 ,差异有显著性意义 (P <0 .0 5) ;病死率分别为 0、2 .5%、9.6%、1 4.3%和 1 5.4% ;开始溶栓至血管再通所需的时间与发病至溶栓的时间呈正相关(P <0 .0 5) ,发病 2 h内为 (58.3± 2 4 ) min,6～ 1 2 h则为 (1 2 6± 30 .3) min。结论 :>70岁老年人AMI发病 6h内溶栓治疗 ,血管再通效果最好 ,但对于发病时间 >6h～ 1 2 h和 >1 2 h～ 2 4 h的患者溶栓治疗仍有较好的效果 Objective: To investigate the effect of thrombolytic therapy on recanalization after acute myocardial infarction (AMI) onset at different times. Methods: One hundred and ninety-nine patients older than 70 years were divided into two groups according to thrombolysis at different time points: ≤2h,> 2-4h,> 4-6h,> 6-12h and> 12 ~ 2 4 h5 group. Results: The recanalization rates of the 5 groups were 80.8%, 75.6%, 71.0%, 47.6% and 46.2%, respectively. There was significant difference between the former 3 groups and the latter 2 groups (P <0. 0 5). The mortality rates were 0,2. 5%, 9.6%, 1 4.3% and 1 5.4% respectively. The time required for initiating thrombolysis to revascularization was positively correlated with the time from onset to thrombolysis (P <0. 0 5). The onset time was (58.3 ± 24) min within 2 h and (120 ± 30.3) min after 6 to 12 h. Conclusion: Thrombolytic therapy and recanalization are the best in the 70-year-old population within 6 hours of onset of AMI, but thrombolytic therapy is still good for patients with onset time> 6 h to 12 h and> 12 h to 24 h Effect