摘要
目的分析溶栓治疗时间对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者院内主要不良心血管事件(major adverse cardiac events,MACE)发生率的影响,为急性STEMI患者溶栓治疗时机的选择提供参考依据。方法以新矿集团莱芜中心医院心血管2012年1月至2016年1月收治的1 173例接受溶栓治疗的急性STEMI患者为研究对象,进行回顾性分析。按照患者溶栓治疗时间分为早期溶栓组(<6 h)、延迟溶栓组(6~12 h)及晚期溶栓组(>12 h),比较各组患者溶通率、MACE发生率,分析溶栓治疗时间对MACE发生率的影响。结果随着患者溶栓治疗时间的增加,其溶通率逐渐下降(88.87%vs.80.55%vs.69.96%,P<0.05),其院内MACE发生率逐渐升高(3.18%vs.5.03%vs.10.73%,P<0.05),差异有统计学意义。结论急性STEMI发生后溶栓治疗时间越短,患者溶通率越高、院内MACE发生率越低,对符合溶栓治疗指征的患者建议于发病6 h内实施静脉溶栓,以保证溶栓效果,降低MACE发生风险。
Objectives To analyze the thrombolytic therapy timing on incidence rate of in hospital major adverse cardiac events （MACE） in patients with acute ST-segment elevation myocardial infarction （STEMI） , and provide a reference for the choice of timing of thrombolytic therapy in patients with acute STEMI. Methods Totally 1 173 patients with acute STEMI received thrombolytic therapy in Laiwu Center Hospital of Xinkuang Group from January 2012 to January 2016 were retrospectively analyzed. The patients were classified into 4 groups according to the timing of thrombolytic therapy： early thrombolysis group （〈6 h）, delayed thrombolysis group （6 to 12 h） and late thrombolysis group （〉 12 h）. Incidences of MACE, successful rates of thrombolysis among the 3 groups were compared. Effect of timing of thrombolytic therapy on incidence of MACE was analyzed. Results With the increasing of the timing of thrombolytic therapy, successful rate of thrombolysis gradually decreased （88.87% vs. 80.55% vs. 69.96%, P〈0.05） , and incidence of MACE gradually increased （ 3.18% vs. 5.03% vs. 10.73%, P〈0.05 ） , the differences were statistically significant （P〈0.05）. Conclusions The timing of thrombolytie therapy in patients with acute STEMI is shorter, the successful rate of thrombolysis is higher, and incidence of MACE is lower. Implementation of intravenous thrombolytie therapy should be performed to the patients accorded with thrombolytic therapy indication with onset within 6 hours, in order to ensure the thrombolytie effect and reduce the risk of incidence of MACE.
出处
《岭南心血管病杂志》
2017年第2期138-141,共4页
South China Journal of Cardiovascular Diseases
关键词
溶栓
急性ST段抬高型心肌梗死
主要不良心血管事件
因素
thrombolysis
acute ST segment elevation myocardial infarction
major adverse cardiac events
factors
