尿激酶溶栓治疗急性心肌梗死58例临床分析

目的　观察急性心肌梗死尿激酶静脉溶栓的疗效。方法　 5 8例急性心肌梗死的患者均符合溶栓疗法的适应证。溶栓前即刻口服阿斯匹林 2 0 0mg后 ,立即给予尿激酶 5 0万u加生理盐水 4 0mL静注 ,继以10 0万u尿激酶加生理盐水 10 0mL静滴 ,30min内滴完。同时应用肝素 10 0mg皮下注射 ,1次 /d连用 5d ,用药期间监测凝血时间。保证凝血时间在参考值的 1 5倍。阿斯匹林次日改为 10 0mg 1次 /d口服。结果　本组 5 8例中溶栓成功 4 1例 ,再通率 70 6 % ,发病 3h内再通率为 88 9% ,3～ 6h者再通率 72 4 % ,6～ 12h者再通率 4 4 4 % ,未通率 2 9 4 %。结论　急性心肌梗死尿激酶静脉溶栓治疗临床再通率高 ,尤其发病在 6h之内者 ,疗效确切 ,简便易行 ,是不具备PTCA条件的基层医院治疗急性心肌梗死的首选方法

Clinical Analysis on Thrombolysis of Acute Myocardial Infarction with Urokinase

Objective To observe the curative effect on thrombolysis of acute myocardial infarction (AMI) with urokinase. Methods 58 cases of AMI patient who were available for thrombolysis therapy were taken aspirin 200mg, 0.5mu of urokinase was injected and 1mu was perfusion intravenously within 30 min for 5 days as a course with heparin 100mg. ACT was monitored and reference ratio was about 1.5 and then aspirin 100mg was given per day. Results 41 cases were successful thrombolysis and recanalization rate was 70.6%. The recanalization rate within 3h was 88.9%, 3～6 h was 72.4%, 6～12 h was 44.4% and obstructive rate was 29.4%. Conclusion The urokinase could recanalized the coronary artery for AMI patient with high ratio especially for those within 6 h with accuracy effect and easy performed. It might be first choice for the hospital without PTCA.