尿激酶溶栓治疗急性心肌梗死

目的探讨尿激酶对急性心肌梗死(AMI)患者溶栓后血管再通率的影响。方法将83例AMI患者随机分为溶栓组(A组)和非溶栓组(B组),溶栓时间窗选择在12 h以内。所有AMI患者均给予常规治疗。A组:立即给予尿激酶1 500 000 U加0.9%氯化钠溶液100 mL静滴,30 min内滴完。溶栓开始后每隔12 h皮下注射低分子肝素钙0.4 mL,连用5 d。B组:给予硝酸甘油、低分子肝素钙及其他常规治疗。观察两组冠状动脉血管的再通情况、再灌注性心律失常及轻微出血发生率。结果两组冠状动脉血管再通率比较,差异有统计学意义(69.77%vs 27.50%,χ2=14.811 0,P<0.01);再灌注性心律失常、轻微出血发生率比较,差异无统计学意义(16.28%vs 12.50%,11.63%vs 10.00%,均P>0.05)。结论尿激酶静脉溶栓治疗能够显著提高AMI患者的冠状动脉再通率,是一种治疗AMI安全、简便、有效的抢救措施,将对AMI患者的预后产生积极的影响。

Urokinase thrombolytic therapy in acute myocardial infarction

Objective To explore the influence of urokinase of acute myocardial infartion(AMI) patients after thrombolysis rate of blood vessels.Methods Eighty-three patients of AMI were divided into thrombolytic group(A group) and non-Thrombolysis Groups(B group).The thrombolytic time window controls in 12 hours.All AMI patients were gieven conventional treatment.Otherwise,A group was infused with urokinase 1 500 000 U plus 0.9% sodium chloride solution 100 mL within 30 minutes drops,and then injected low molecular weight heparin calcium 0.4 mL every 12 hours after thrombolytic therapy starting for 5 days,B group was given conventional treatment with nitroglycerin and low molecular weight heparin calcium etc.Then we appraised the recanalization of coronary artery,reperfusion arrhythmia and mild bleeding incidence.Results Between the two groups,there are significant differences(69.77% vs 27.50%,χ2=14.811 0,P < 0.01) in coronary artery recanalization rate,and no statistically significant difference(16.28% vs 12.50%,P > 0.05 and 11.63% vs 10.00%,P > 0.05) in reperfusion arrhythmia and the incidence of minor bleeding.Conclusion Intravenous thrombolysis treatment with urokinase can significantly improve coronary artery recanalization rates in AMI patients,it is a safe,simple and effective rescue measures,and has a positive effect on the prognosis of AMI patients.