急性心肌梗塞肝素加阿司匹林抗凝治疗对梗塞相关冠状动脉内血栓自溶的影响

为探讨急性心肌梗塞肝素加阿司匹林抗凝治疗对梗塞相关冠状动脉内血栓自溶的影响,我们观察了45例急性心肌梗塞肝素加阿司匹林抗凝治疗,22例尿激酶溶栓治疗和21例心肌梗塞常规治疗冠状动脉造影情况,其结果为:急性心肌梗塞肝素加阿司匹林抗凝治疗对梗塞相关冠状动脉血栓自溶率为42.2%,溶栓治疗梗塞相关冠脉再通率为68.2%,常规治疗梗塞相关冠状动脉内血栓自溶再通率为14.3%.三组间有显著差异(X~2=12.78,P<0.01).结论是肝素加阿司匹林抗凝治疗急性心肌梗塞能促进冠状动脉内血栓自溶,提高梗塞相关冠脉再通率,但血栓自溶缓慢,冠脉再通延迟,对挽救梗塞区域心肌坏死作用不大.然而,对改善心肌电稳定性和心肌缺血区域的供血有积极的临床意义.

Effect of Haparin Plus Aspirin Treatment on the Self-absolving of Infarction related Intracoro- nary Emboli

45 patients with acute myocardial infarction (AMI) have been treated with haparin plus aspirin. Controls were 22 patients with AMI treated with Urokinase and 21 patients with AMI treated with conventional methods. The absolving effect on infarction related coronary emboli was evahated with coronary angiography Results showed that the reopenning rates were 42. 2% in haparin plus aspirin treated group 68. 20% in Urokinase treated group and 14. 3% in conventionally treated group respectively. There was significant difference among these three groups (X2 = 12. 78, P<0. 01). In conclusion. heparin plus aspirin treatment can promote the selfabsolving of intraco-ranary emboli, increase the openning rate of infarction related emboli but the effect is very slow. . Therefore, the haparin plus aspirin treatment is not significant in preventing the necrosis of myocardium in the area of infarction. Nevertheless, this approach can improve the electrostability of myocardium and circulation in the area of ischemia.