急性心肌梗死溶栓治疗的疗效观察

目的：观察急性心肌梗死（AMI）溶栓治疗的临床疗效.方法：52例AMI患者均进行心肌梗死常规治疗,根据是否行尿激酶溶栓治疗分为治疗组（43例）和对照组（9例）.观察2组患者的治疗效果,包括病死率、冠状动脉再通情况、不良反应和并发症.结果：使用尿激酶溶栓治疗后7 d,治疗组43例冠状动脉再通率为67.4%（29/43）,病死率为7.0%（3/43）,未发生溶栓治疗相关的消化道出血及颅内出血等严重并发症.对照组9例冠状动脉再通率为33.3%（3/9）,病死率为22.2%（2/9）.结论：在不能行急诊经皮冠状动脉介入治疗及无溶栓禁忌症情况下,溶栓治疗是AMI的首选治疗方法.

Outocmes of thrombolysis in acute myocardial infarction

Objective： To investigate the effects of thrombolysis in patients with acute myocardial infarction （ AMI ）. Methods： Fifty-two patients with AMI received conventional therapy for myocardial infarction, and were then divided into two groups according to addition of thrombolytic therapy with urokinase or not （ urokinase treated group, n = 43 ; control group, n = 9 ）. The outcomes in the two groups, including case fatality, recanalization of coronary artery,adverse reactions and complications, were studied and compared. Results： Seven days after thrombolytic therapy with urokinase, the rate of coronary artery recanalization and the case fatality were 67.4% （ 29/43 ） and 7.0% （ 3/43 ） , respectively,in the urokinase treated group,compared with 33.3% （3/9） and 22. 2% （2/9） in the control group. Moreover, severe complications related with thrombolytic therapy, such as gastrointestinal tract bleeding or intracranial hemorrhage, were not reported among patients on urokinase. Conclusion： Among AMI patients not indicated for emergency treatment with percutaneous coronary intervention but eligible for thrombolysis, thrombolytic therapy can be the first choice.