急性心肌梗塞患者早期应用低分子肝素钙对溶栓疗效的影响

目的:探讨早期应用低分子肝素钙(LMWH)对急性心肌梗塞患者溶栓疗效的影响。方法:第一组(43例,溶栓前应用LMWH 尿激酶组):入院后立即腹壁皮下注射LMWH5000IU,抗凝后平均(40±20)min使用尿激酶150万U溶栓。第二组(45例,尿激酶 溶栓后2h应用LMWH组):入院后(40±20)min使用尿激酶150万U溶栓,溶栓后2h应用LMWH5000IU腹壁皮下注射。第三组(42例,常规尿激酶溶栓组),常规溶栓后6h应用LMWH5000IU腹壁皮下注射。冠状动脉再通标准为同时具备1996年7月太原会议参考方案中间接指征的2项或2项以上。结果:第一组43例中37例再通(再通率83.7%)。第二组45例中再通35例(77.78%)。第三组42例中再通24例(57.14%)。第一组和第二组血管再通率差异无显著性(P>0.05),第一组与第三组血管再通率差异有极显著意义(P<0.01);第二组与第三组血管再通率差异有显著意义(P<0.05)。结论:早期应用低分子肝素抗凝可提高急性心肌梗塞患者的溶栓成功率。

Effectiveness of early use of low molecular-weight heparin calcium for thrombolytic therapy in patients with acute myocardial infarction

Objective:To evaluate the effectiveness of early use of low molecular-weight heparin(LMWH) calcium for thrombolytic therapy in patients with acute myocardial infarction(AMI).Methods:The 43 patients in group 1 were injected 5000 U LMWH before thrombolytic therapy and then received 1.5 million U urokinase after 20~60 min.The 45 patients in group 2 received 1.5 million U urokinase for thrombolytic therapy and then were injected 5000 U LMWH after 2 h.The 42 patients in group 3 were injected 5000 U LMWH after normal thrombolytic therapy 6 h later. The standard of re-vascularization for coronary artery was in accordance with two or more items of the reference draft drawn up in Taiyuan conference in 1996.Results:The 37 of the 43 cases(83.7%) in group 1 achieved re-vascularization.The 35 of the 45 cases(77.8%) in group 2 achieved re-vascularization.Only 24 of the 42 cases(57.14%) in group 3 achieved re-vascularization.The rate of re-vascularization between group 1 and 2 showed no statistical difference(P>0.05) while the difference between group 1 and 3 was very significant(P<0.01),and the difference between group 2 and 3 was also significant(P<0.05).Conclusion:The early use of low molecular-weight heparin calcium for thrombolytic therapy in patients with acute myocardial infarction improves the cure rate.