尿激酶早期静脉溶栓治疗急性心肌梗死的疗效观察

目的：探讨尿激酶早期静脉溶栓治疗急性心肌梗死的疗效价值及安全性。方法：选择2008年2月～2009年10月本院收治的急性心肌梗死患者72例,并随机分为对照组和观察组各36例,对照组给予吸氧、卧床、监护、硝酸甘油、低分子肝素、中药活血化瘀等常规治疗;观察组除采用常规治疗以外加静脉溶栓治疗,采用1000000U尿激酶加入0.9%NaCl溶液100ml中静滴,30min内滴完。比较两组的临床疗效及肌酸激酶（CK）、磷酸肌酸激酶同工酶（CK-MB）的水平变化。结果：观察组显效率为30.56%,总有效率为83.33%;对照组显效率为5.56%,总有效率为38.89%,两组比较差异有统计学意义（P〈0.05）。观察组治疗24h后,肌酸激酶（CK）、磷酸肌酸激酶同工酶（CK-MB）水平较治疗前明显下降,差异有统计学意义（P〈0.05）,对照组治疗前后CK、CK-MB无明显变化,差异无统计学意义（P〉0.05）,观察组明显低于同期对照组治疗水平,差异有统计学意义（P〈0.05）。结论：尿激酶早期静脉溶栓治疗急性心肌梗死安全、方便、有效,应用较方便,值得在基层医院推广应用。

Observation of early intravenous thrombolysis with urokinase treatment for acute myocardial infarction

Objective：To study the value and safety of the early intravenous thrombolysis with urokinase treatment for acute myocardial infarction.Methods：Selected from February 2008 to October 2009 admitted to our hospital 72 patients with acute myocardial infarction and were randomly divided into control group and observation group,and each for 36 pa tients,in the control group given oxygen,bed rest,guardianship,nitroglycerin,low molecular weight heparin,Chinese medicine blood stasis and other conventional treatment;Observer group in addition to conventional treatment with intra venous thrombolytic therapy outside the use of 1 million U of urokinase by adding 100 ml of 0.9% normal saline infusion,30 min end inside the drops.Compared the two groups of clinical efficacy and creatine kinase（CK）,myocardial creatine phosphate enzymes（CK-MB） levels of change.Results：Observation group were 30.56% efficiency,with a total effective rate was 83.33%;control group,markedly effective rate of 5.56%,with a total effective rate was 38.89%,the difference was sta tistically significant（P〈0.05）.24 h post-treatment observation group,creatine kinase（CK）,myocardial creatine phosphate enzymes（CK-MB） levels decreased significantly compared with before treatment,the difference was statistically significant（P〈0.05）,the control group before and after treatment CK,CK-MB no significant change in the difference was not statisti cally significant（P〈0.05）,the observation group were significantly lower than the level of cycles in the control group,the difference was statistically significant（P0.05）.Conclusion：Early intravenous thrombolysis with urokinase for acute myocardial infarction safe,convenient,effective and more convenient to use,it is worth popularization and application of the hospital at the grassroots level.