Katona A, Deli L, Hutter K
Békés Megyei Képviselötestület Pándy Kálmán Kórháza, Gyula, II. sz. Belgyógyászati Osztály--Kardiológia.
Orv Hetil. 1995 Jun 18;136(25):1319-22.
Authors surveyed the data of 2677 patients with acute myocardial infarction treated in cardiological department between 1970 and 1993. Activity of Coronary Care Unit (has been working from 1974) reduced the earlier hospital mortality in general internal medicine possibilities with 50%. Main cause of this reduction was the temporal electrotherapy of cardiac arrhythmias. Since the middle of last decade the goal of has been generally introduced combined therapy (beta-blockers, intravenous nitrates, acetyl-salicic acid, thrombolytics) is to reduce the mass of damaged myocardium and hereby increasing the ratio of survival. They reduced the hospital mortality around 10% with consistent application of this therapy. According to the authors application of thrombolytic therapy has basic importance in management of myocardial infarction, but they could not treat a lot of patients with streptokinase in consequence of too long prehospital time period and not properly controlled hypertension. The proportion of systemic thrombolytic therapy on their patients is almost a quarter of them. It would be very important to increase this beneficial ratio with reducing the time of patients decision to turn to health care and applying systemic thrombolytic therapy more than six hours after the onset of symptoms of myocardial infarction.
作者调查了1970年至1993年间在心脏病科接受治疗的2677例急性心肌梗死患者的数据。冠心病监护病房（自1974年开始运作）的启用使普通内科患者的早期医院死亡率降低了50%。死亡率降低的主要原因是心律失常的临时电疗法。自上世纪八十年代中期以来，普遍采用的联合治疗（β受体阻滞剂、静脉注射硝酸盐、乙酰水杨酸、溶栓剂）的目标是减少受损心肌的数量，从而提高生存率。持续应用这种疗法可使医院死亡率降低约10%。据作者称，溶栓疗法在心肌梗死的治疗中具有至关重要的作用，但由于院前时间过长和高血压控制不当，他们无法用链激酶治疗很多患者。接受全身溶栓治疗的患者比例几乎占四分之一。通过减少患者决定寻求医疗护理的时间，并在心肌梗死症状出现后超过6小时应用全身溶栓治疗来提高这一有益比例将非常重要。
