早期应用低分子肝素对急性心肌梗死患者溶栓疗效的影响

目的探讨对急性心肌梗死患者早期应用低分子肝素的治疗效果。方法将120例急性心肌梗死患者随机分为对照组与观察组各60例，观察组于人院后溶栓治疗前30～60min予低分子肝素5000IU腹壁皮下注射，对照组于溶栓治疗开始后12h给予低分子肝索5000IU腹壁皮下注射，对比两组再通及副反应情况。结果观察组53例再通，再通率88．3％，对照组41例再通，再通率68．3％，两组比较差异有统计学意义（P〈0．01），观察组再通时间为（1．3±0．6）h，对照组为（1．9±0．4）h，两组比较差异有统计学意义（P〈0．01）；两组出血情况比较差异无统计学意义（P〉0．05）。结论溶栓治疗前早期应用低分子肝素对于提高急性心肌梗死患者血管再通率、缩短再通时间有积极意义，且疗效肯定，安全可靠。

Effectiveness of early use of iowmolecular weight heparin calcium for thrombolytic therapy in patients with acute myocardial infarction

Objective To discuss the effectiveness of early use of low -molecular weight heparin（LMWH） for thrombolytic therapy in patients with acute myocardial infarction. Methods 120 patients with acute myocardial infarction were divided into the control group（60 patients） and the observation group （60 patients） randomly, the 60 patients in the observation group were injected 5000 IU LMWH before thrombolytic therapy and then received 1.5 million U uroklnase after 30 - 60 minites, and the 60 patients in the control group received 1.5 million U urokinase first and then were injected 5000IU LMWH after 12 hours. We compared the revaseularization rate for coronary artery and the bleeding risk between the two groups. Results 53 patients of the observation group reached the standard of revascularization for coronary artery,the revascularization rate was 88. 3% ,significantly higher than the control group（P 〈0. 01 ）. The revascularization time of the observation group were （ 1.3 ±0. 6） hours,was significantly shorter than the control group（ P 〈 0. 01 ）. But the bleeding risk between the two groups had no significant difference （ P 〉 0. 05 ）. Conclusion Early application of low molecular weight heparin for acute myocardial iiffarction can improve the recanalization rates, shorten the rceanalization time, and was more effective, safe and reliable.