House M A
AACN Clin Issues Crit Care Nurs. 1992 Feb;3(1):106-13. doi: 10.4037/15597768-1992-1013.
Coronary artery disease is the most common cause of death in persons older than 65 years. More than half of all patients hospitalized for acute myocardial infarction (AMI) are now older than 65, with this percentage expected to increase significantly in subsequent years. The current evidence regarding the treatment of AMI indicates that early thrombolytic therapy can limit the extent of myocardial necrosis, preserve left ventricular function, decrease the incidence of congestive heart failure, and reduce mortality in patients with AMI. Most studies have adhered to empiric recommendations to exclude elderly patients, based on the assumption that in the elderly the risks of serious hemorrhagic complications after thrombolytic therapy outweigh the potential benefits of early reperfusion. This article reviews the current literature regarding use of thrombolytic agents in treating AMI in the elderly population with some guidelines for protocol formation.
冠状动脉疾病是65岁以上人群最常见的死因。目前，因急性心肌梗死（AMI）住院的患者中，超过一半年龄在65岁以上，预计这一比例在随后几年将显著上升。目前有关AMI治疗的证据表明，早期溶栓治疗可限制心肌坏死范围、保留左心室功能、降低充血性心力衰竭的发生率，并降低AMI患者的死亡率。大多数研究遵循经验性建议将老年患者排除在外，其依据是认为老年人溶栓治疗后发生严重出血并发症的风险超过早期再灌注的潜在益处。本文回顾了有关在老年人群中使用溶栓药物治疗AMI的当前文献，并提出了一些制定方案的指导原则。
