小剂量尿激酶治疗不稳定型心绞痛79例

目的:观察小剂量尿激酶(UK)与低分子肝素联合治疗不稳定型心绞痛(UAP)的临床疗效.方法:158例患者随机分成治疗组和对照组,每组79例.治疗组应用UK 0.5万IU/kg,于30 min内静脉滴入,连续3 d;在第1天静脉滴注UK前1 h先静脉注射低分子肝素25 mg,然后低分子肝素1 mg/kg皮下注射,1次/d,共6 d;对照组不用UK,其他治疗同治疗组.主要比较指标为30 d内病死率和心肌梗塞发生率,并观察治疗组治疗前后凝血指数变化.结果:30 d内心脏事件两组间差异显著(P＜0.05),急性心肌梗塞发生率治疗组明显低于对照组(P＜0.05),频发心绞痛发生率的减少亦优于对照组(第1周,P＜0.01;第4周,P＜0.05).治疗组治疗前后凝血指数变化有显著性差异(P＜0.05).结论:小剂量尿激酶与低分子肝素联合治疗UAP可明显降低急性心肌梗塞和频发心绞痛的发生率.

Clinical Effect of Low- dose Urokinase on Unstable Angina

Objective:To investigate the clinical effect of low-dose urokinase(UK)in combination with enoxaparin on unstable angina(UA). Methods:The study was conducted in 158 patients with UA,They were randomly divided into low-dose UK group and placebo group,79 patients each group.In low-dose UK group.low-dose UK 5000 IU/Kg was given per 30 min for 3 d,in combination with enoxaparin 1 mg/Kg once daily for 6 d,Enoxaparin 25 mg IV bolus was given 1 h before low-dose UK thrombolytic therapy in the first day of admission.Enoxaparin was the same in low-dose UK group and placebo group.The main indexes for the comparison between the low-dose UK and placebo groups were fatality rate and incidence of AMI(cardiac event)within 30 d of enrollment.To observe change of coagulation indexes in low-does UK group befor and after the treatment.Results:There was statistically significant difference in cardiac event between two groups,(P < 0.05) the rate of AMI in low-dose UK group was much lower than that in placebo group,the differentce was significant(P < 0.05).The incidence of frequent angina significantly decreased inpatients treated with low-dose UK as compared with patients in placebo(P < 0.05).The difference of the change of coagulation indexes in low-dose UK group was significant before and after the trentment.Conclusion:Using low-dose UK in combination with enoxaparin might remarkably reduce the risk of AMI and the incidence of frequent angina.