Steffensen R, Grande P, Clemmensen P M, Sandøe E
Medicinsk afdeling B, Rigshospitalet, København.
Ugeskr Laeger. 1995 Apr 17;157(16):2302-5.
The present study describes the use of intravenous thrombolytic therapy, the in-hospital and the long-term mortality in a cohort of 1881 consecutive patients with confirmed myocardial infarction. Thirty-two percent received thrombolytic therapy. Common reasons for not administering thrombolytic therapy were contraindications, diagnostic problems and late hospital admission. The total in-hospital mortality was 14% among patients treated with, and 27% among those treated without thrombolytic therapy (p < 0.001). The mortality among all patients after 48 months of follow-up was 50%. Advanced age, previous myocardial infarction and a higher Killip class on admission were independent predictors of an adverse outcome. In conclusion, in an unselected population with confirmed myocardial infarction the long-term prognosis continues to be dubious, despite the advances in coronary care including intravenous thrombolytic therapy.
本研究描述了1881例连续确诊心肌梗死患者队列中静脉溶栓治疗的使用情况、住院死亡率和长期死亡率。32%的患者接受了溶栓治疗。未进行溶栓治疗的常见原因包括禁忌证、诊断问题和住院延迟。接受溶栓治疗的患者住院总死亡率为14%,未接受溶栓治疗的患者为27%(p<0.001)。随访48个月后,所有患者的死亡率为50%。高龄、既往心肌梗死和入院时较高的Killip分级是不良结局的独立预测因素。总之,在未经选择的确诊心肌梗死人群中,尽管包括静脉溶栓治疗在内的冠心病护理取得了进展,但长期预后仍然不确定。