低分子肝素联合尿激酶静脉溶栓治疗急性心肌梗死的临床疗效和安全性评价

目的：对低分子肝素联合尿激酶静脉溶栓治疗急性心肌梗死的临床疗效及安全性进行评价。方法将46例急性心肌梗死患者随机分为溶栓组23例（溶栓再通组和溶栓未通组）、未溶栓组23例，通过低分子肝素联合尿激酶对溶栓组患者进行治疗；使用常规方法治疗未溶栓组患者，无溶栓治疗，对三组患者的射血分数、治疗效果以及死亡率进行观察。结果17例溶栓再通者（73.9%）显著高于6例溶栓未通者（26.1%）（P＜0.05）；溶栓再通组总有效率为88.2%，显著高于66.7%的溶栓未通组、65.2%的未溶栓组（P均＜0.05）。结论急性心肌梗死采用低分子肝素联合尿激酶的静脉溶栓治疗可有效降低死亡率、提升冠状动脉的再通率以及改善预后。

Clinicalefficacyandsafetyevaluationoflowmolecularweightheparin combined with urokinase intravenous thrombolysis in treatment of acute myocardial infarction

Objective To evaluate the clinical efficacy and safety of low molecular weight heparin combined with urokinase intravenous thrombolysis in the treatment of acute myocardial infarction. Methods Forty-six patients with acute myocardial infarction were randomly divided into the thrombolysis group（thrombolysis re-patency group and thrombolysis non-patency group） with 23 patients and the non-thrombolysis group with 23 patients. The thrombolysis group received low molecular weight heparin combined with urokinase treatment;The non-thrombolysis group received conventional treatment, without thrombolysis treatment. The blood ejection fractions, treatment effects and mortality rates of the three groups of patients were observed. Results The 17 patients with thrombolysis re-patency（73.9%） were significantly higher than the 6 patients with thrombolysis non-patency（26.1%）（P〈0.05）. The total effective rate of the thrombolysis re-patency group was 88.2%, which was significantly higher than the 66.7%of the thrombolysis non-patency group and the 65.2%of the non-thrombolysis group（P 〈 0.05 for all）. Conclusion In the treatment of acute myocardial infarction, the application of low molecular weight heparin combined with urokinase intravenous thrombolysis can effectively reduce the mortality rate, promote the re-patency rate of coronary artery and improve prognosis.