静脉溶栓序贯给药法对急性心肌梗塞冠脉再通疗效的观察

目的观察静脉溶栓序贯给药法对急性心肌梗塞早期冠脉再通的疗效。方法２０５例ＡＭＩ患者随机分成序贯组（溶栓前肝素－尿激酶－溶栓后肝素）１０７例，和对照组（９８例）。尿激酶溶栓前序贯组先用肝素５０００Ｕ，而对照组只用安慰剂（尿激酶－肝素）。结果序贯组的早期冠脉再通率明显高于对照组，分别为７１．０３％和５２．０４％，Ｐ＜０．０１，前者的ＳＴ段回落和Ｔ波反转也明显快于后者。两组出血并发症相似。结论静脉溶栓序贯给药法明显提高早期冠脉再通率而不增加出血危险性。

Effect of Sequential Usage of Intravenous Thrombolysis on Coronary Patency in Acute Myocardial Infarction

Objective To Study the effect of a sequential usage of intravenous thrombolysis(pre thrombolytic heparin urokinase postthrombolytic heparin) on early coronary patency in patients with acute myocardial infarction. Method The 205 patients were divided into two groups randomly. The sequential group of 107 cases were treated with heparin (5000U) urokinase posttromb*lytic h*parin. 98 cases as control group were given only placebo urokinase heparin. Results The early coronary patency rate was higher in the sequential group than in the control group (71.03% and 52.04% respectively, P<0.01). The fall after rise of ST segment and T wave inversion were far earlier in the former group than in the latter (P<0.005).Bleeding complications were similar between the two groups. Conclusion The sequential usage of intravenous thrombolysis improves the rate of early coronary patency obviovsly, and doesn’t increase the risk of bleeding.