急性心肌梗塞国产尿激酶50万和75万单位静脉溶栓临床对照研究  

Clinical comparsion study on the intravenous thrombolysic effects of Chinese-made urokinase(500000～750000 units)in acute myocardial infarction

作　　者：张柱国[1] 蒋小燕[1] 王雪里红 贾佳[1] 孟昭兰 单沙林[1] 王克英[1] 

机构地区：[1]北京急救中心内科,100031

出　　处：《中国危重病急救医学》1993年第1期10-14,共5页Chinese Critical Care Medicine

摘　　要：为了确定国产尿激酶的有效剂量,我们对发病≤12h的急性心梗患者进行50万和75万单位静脉溶栓临床对照研究,对照组22例,50万组23例,75万组33例。结果:梗塞有关的冠脉早期再通率对照组为零,尿激酶50万和75万单位组分别为13.04%和42.42%,P<0.05,与对照组比较50万单位组P>0.05,75万单位组P<0.05;出院时梗塞面积对照组扩大,尿激酶50万和75万单位组缩小(P<0.05),与对照组比较50万单位组P>0.05,75万单位组P<0.05;呈现心肌挽救的患者对照组占11.11%,尿激酶50万和75万单位组分别为38.87%和42.84%,与对照组比较P分别>0.05和<0.05,证明国产尿激酶静脉溶栓50万单位剂量不足,75万单位为有效剂量。溶栓后50万和75万单位组静脉给肝索总出血率分别为12.5%和50%,P<0.05,75万单位组皮下给肝素总出血率为16.66%,与75万单位静脉给肝素比较P<0.05,与未用者比较P>0.05,说明国产尿激酶溶栓后出血发生率与尿激酶剂量、应用肝素和肝素给药方法有关,皮下给肝素安全有效、值得推广。In order to determin the effective dosage ofChinese-made urokinase(UK)in intravenousthrombolysis,we made a clinical comparison study onits dosage(500 000～750 000 unite)in patients withmyocardial infarction Within 12 hours after the attact.78 patients were studied,with 22 in the control group(group 1),23 in the 500 000-unit group(group 2),and 33 in the 750 000-unit group(group 3).The patency rates of the infarct-related coronaryarteries in our study were:0 in group 1,13.04% ingroup 2 and 42.42% in group 3(P<0.05).Pwas>0.05 when group 2 was compared with group 1,and<0.05 when group 3 was compared with group.1.The area of AMI was increased in group 1 whendischarged,while it was decreased in group 2 and 3(P<0.05)P was>0.05 when group 2 was comparedwith group 1.and<0.05 when group 3 was comparedwith group 1 Myocardial rescue was seen in 11.11% ofthe patients in group 1,38.87% in group 2 and42.84% in group 3,P was>0.05 when group 2 wascompared with group 1,and<0.05 when group 3 wascompared with group 1.This showed that 500 000units of Chinese-made UK were not enough for AMIintravenous thrombolysis but 700 000 units wereeffective. After intravenous administration of UK,the pa-(?)nts were given heparin by iv drip or subcutaneously.With iv heparin,the hemorrhage rate was 12.5% ingroup 2 and 50% in group 3(P<0.05).Whensubcutaneous heparin was given in group 3,thehemorrhage rate was 16.66%(P<0.05 compared withiv drip).The result indicated that hemorrhage rate wasrelated to the dosage of UK,heparin administrationand its methods.Subcutaneous heparin is effective andsafe.

关 键 词：尿激酶 溶栓疗法 心肌梗塞 

分 类 号：R542.220.5[医药卫生—心血管疾病]