急性心肌梗塞患者早期尿激酶溶栓治疗甲襞微循环动态研究

目的：动态观察急性心肌梗塞（AMI）病人早期尿激酶（UK）溶栓治疗甲襞微循环变化，并探讨其发生的可能机制，为临床AMI的治疗及再灌注损伤（RI）的预防提供理论依据。方法：运用显微电视录像系统结合加权积分法对21例AMI病人甲襞微循环进行研究。结果：再灌注即刻，血液流态恶化（P＜0．01）；再灌注心律失常发生率与血液流态积分值有关（P＜0．05）。结论；1、AMI早期UK治疗随冠脉再通，甲襞微循环特征性改变为红细胞高度聚集，白微栓大量形成即血流状态的恶化。提示纤溶的同时凝血功能亢进。支持AMI溶栓前后应用ASA、肝素等抗凝治疗。2、微循环异常改变参与AMI及RI发生和发展，临床应加以重视。

Dynamic changes observation nailfold microcirculafion in patients with acute myocardial infarction during thrombolytic therapy of urokinase

Nailfold microcirculation in 21 patients with acute mycardial infarction(AMI) during thrombolytic therapy of urokinase were observed and investigate its mechanisms,provide scientific basic for clinical treatment of AMI. By videomicroscope and computer analysis and the methods of weighting integrat value,nail fold microcirculation was studied in 21 patients with AMI. Immediately after completion of UK infusion,blood flow pattern was worsened;Reperfusion arrhythmias related to integrate value of blood flow pattern.Characteristic changes of nailfold microcirculation in patients with AMI during thrombolytic therapy of urokinase were RBC aggregatin, microthrombo production,the use of thrombolytic angent and blood coagulation were enhanced,and support the methods of ASA or Heparin treatment in AMI. Microcirculation disturbancetake part in the total course of AMI and reperfuson injury.