静脉溶栓时机对急性ST段抬高型心肌梗死患者溶栓效果及主要不良心脏事件发生率的影响

目的:探讨静脉溶栓时机对急性ST段抬高型心肌梗死患者溶栓效果及主要不良心脏事件发生率的影响。方法:将2016年1月至2017年12月我院接诊的314例急性ST段抬高型心肌梗死患者纳入本研究,按照溶栓治疗时间不同分为A组(发病至溶栓时间6 h)172例、B组(发病至溶栓时间为6～12 h)102例和C组(发病至溶栓时间12 h)40例,比较三组患者溶栓效果、溶栓后ST段回落情况以及住院期间主要不良心脏事件发生情况。结果:A组患者梗死冠脉溶通率、溶栓后ST段回落幅度高于B组和C组,且B组高于C组,差异均有统计学意义(P0.05)。A组患者治疗后ST段回落最大幅度所需时间、住院期间主要不良心脏事件总发生率低于B组和C组,且B组低于C组,差异均有统计学意义(P0.05)。结论:急性ST段抬高型心肌梗死患者发病后6 h内静脉溶栓治疗梗死冠脉溶通率更高、ST段回落效果更好,可降低住院期间主要不良心脏事件发生风险。

Effect of Time of Thrombolytic Therapy on Thrombolytic Effect and Incidence of Major Adverse Ardiac Events in Patients with Acute ST-segment Elevation Myocardial Infarction

ABSTRACT Objective: To explore the effect of time of thrombolytic therapy on thrombolytic effect and incidence of major adverse cardiac events in patients with acute ST-segment elevation myocardial infarction. Methods: 314 patients with acute ST segment elevation myocardial infarction admitted to our hospital from January 2016 to December 2017 were included in this study. According to the time of thrombolytic therapy, the patients were divided into A group (onset to thrombolytic time<6 h) with 172 cases, B group (the onset to thrombolytic time at 6~12 h) with 102 cases and C group (onset to thrombolytic time>12 h) with 40 cases. The thrombolytic effect, ST segment fall after thrombolysis and the incidence of major adverse cardiac events were compared between the three groups. Results: The thrombolysis rate of infarction coronary artery and ST segment fall after thrombolysis in A group were higher than that of B group and C group, and B group was higher than that of C group, the differences were statistically significant(P<0.05). The required time for ST segment maximum fall after thrombolysis and the total incidence of major adverse cardiac events in A group during hospitalization were lower than that of B group and C group, and B group was lower than that of C group, the differences were statistically significant(P<0.05). Conclusion: Patients with acute ST segment elevation myocardial infarction are received intravenous thrombolytic therapy within 6 h after onset, the thrombolysis rate of infarction coronary artery is higher, and the effect of ST segment fall is better, which can reduce the risk of major adverse cardiac events during hospitalization.