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目的 :评价尿激酶 (UK)静脉溶栓治疗老年人 (≥ 60岁 )甚至高龄 (>70岁 )急性心肌梗死 (AMI)患者的疗效及安全性。方法 :将 2 81例 AMI患者按年龄段分成〔<60岁 (1 1 8例 )、60～ 70岁 (99例 )、>70岁 (64例 )〕3组 ,并对其中 1 63例老年 AMI患者的近期预后进行分析 (以同期未接受溶栓治疗的 46例老年 AMI患者作为对照组 )。结果 :随年龄增加 ,血管再通率逐渐下降 (P >0 .0 5) ,而病死率和出血反应有升高趋势 (P >0 .0 5) ;对老年 AMI患者慎用 UK 2 0 0万 IU以免诱发脑出血 ;老年 AMI患者溶栓组的病死率及治疗后主要并发症均显著或非常显著地低于未溶栓组 (P <0 .0 5或 <0 .0 1 )。结论 :老年甚至高龄 AMI患者接受溶栓治疗可显著改善近期预后 ,但剂量应偏小
PURPOSE: To evaluate the efficacy and safety of intravenous thrombolysis with urokinase (UK) in the treatment of acute myocardial infarction (AMI) in the elderly (≥60 years) and even in elderly (> 70 years) patients. Methods: A total of 2 81 AMI patients were divided into 3 groups according to their ages: 60 patients (<60 years old), 60-70 years old (99 cases), and> 70 years old (64 cases) Short-term outcomes in patients with AMI were analyzed (46 patients with AMI who did not undergo thrombolysis during the same period as a control group). Results: With the increase of age, the rate of recanalization decreased gradually (P> 0.05), while the mortality and hemorrhage reaction increased (P> 0.05). The elderly patients with AMI should be cautiously treated with UK 200 In the elderly patients with AMI, the mortality of the thrombolytic group and the major complications after AMI were significantly or very significantly lower than those without the thrombolytic group (P <0.05 or <0.01). Conclusions: Thrombolytic therapy in elderly and even elderly patients with AMI can significantly improve the short-term prognosis, but the dose should be small