急性心肌梗死静脉溶栓临床研究

目的　观察急性心肌梗死静脉溶栓的临床疗效及血管再通与死亡、溶栓时间、并发症、心功能之间的关系。方法　尿激酶 15 0万U加入 5 %葡萄糖溶液 10 0ml中于半小时内静脉滴入。结果　 14 2例急性心肌梗死静脉溶栓后血管再通 80例 ( 5 6.3 4%) ,血管未通 62例 ( 4 3 .66%) ,死亡 9例 ( 6.3 4%) ,其中血管再通组和未通组死亡率分别为 2 .5 0 %和 11.2 9%(P <0 .0 1) ;再通组心衰、休克、严重心律失常的发生率均明显低于未通组 ,心输出量及左室射血分数明显高于未通组 ;溶栓在急性心肌梗死发作 6h内开始者其血管再通率明显 >6h以上者。结论　对有溶栓指征而无禁忌证的急性心肌梗死患者尽早开始溶栓治疗 ,可以减少并发症 ,改善心功能 ,降低死亡率

Clinical Study of Acute Myocardial Infarction by Dissolving Thrombi with Urokinase

Objective To observe the curative efficacy on treatment for patients with acute myocardial infarction by dissoluteion of thrombi with urokinase and to find out the relationship between intravenous thrombolytic patency and mortality,time of dissolution of thrombi,complications,cardiac functions.Methods Dissolve 1 500 000 IU uroknase in 100 ml 5% glucose injection prior to infusion and then administer within half a hour. Results 80 cases' thombi (56.34%) were successfully dissolved and 62 cases (43.66%) were unsuccessful;there were 9 patients dead (6.34%) among total numbers during the treatment;the death rate of the success groups and the unsuccess groups was respectively 2.50% and 11.29%( P <0.01).Furthermore the succeeding groups' complications (such as the heart failing,shock and serious cardiac arrhythmia) was much lower than those of unsuccess groups,meanwhile we found that the cardiac output (CO) and left ventricular ejection fraction (LVEF) were much more higher than those of unsuccess groups;the success rate of dissolution of thrombi within the first 6 hours was much higher than that of upwards of 6 hours. Conclusion Basis on our clinical treatments observation,wheen treating AMI patients,if having dissolving thrombi symptoms and no forbid symptoms,we should try to dissolve thrombi as soon as we can,because through this method we can reduce the complications and improve cardiac function,the most important, the most important thing is that we decrease the mortality.