Arntz H R
Department Cardiopulmology, Benjamin Franklin Medical Center, Free University of Berlin, Hindenburgdamm 30 D-12200, Berlin, Germany.
Thromb Res. 2001 Sep 30;103 Suppl 1:S91-6. doi: 10.1016/s0049-3848(01)00303-6.
Efficacy of reperfusion therapy in acute myocardial infarction (AMI) is strictly time-dependent. Most benefit is achieved with initiation of therapy within the first 60-90 min after onset of symptoms. The majority of patients with AMIs are seen within this time window by emergency medical services. Moreover, average time gain of about 60 min is possible by prehospital thrombolysis. Randomized studies yielded a better outcome when a time gain of 90 min and more was achieved. Prehospital diagnosis of AMI is reliable. Moreover, out-of-hospital thrombolysis has no additional specific risks nor is it an obstacle for later percutaneous intervention. Consequently, patients seen within the first 60-90 min after onset of symptoms or for whom a time gain of 90 min or more can be expected should receive immediate prehospital thrombolysis.
再灌注治疗在急性心肌梗死（AMI）中的疗效严格依赖于时间。在症状发作后的最初60 - 90分钟内开始治疗可获得最大益处。大多数AMI患者在这个时间窗内被紧急医疗服务机构接诊。此外，院前溶栓可使平均时间缩短约60分钟。当时间缩短达到90分钟及以上时，随机研究显示出更好的结果。AMI的院前诊断是可靠的。而且，院外溶栓没有额外的特定风险，也不会成为后续经皮介入治疗的障碍。因此，在症状发作后最初60 - 90分钟内就诊的患者，或者预计时间缩短能达到90分钟及以上的患者，应接受立即的院前溶栓治疗。
