溶栓治疗老年人弥漫性严重冠脉病变的临床观察  

Clinical study of thrombolysis in elderly patients with serious coronary lesions

作　　者：王小冬[1] 陈士良[1] 张金萍[1] 刘晓靖[1] 杨利锋[1] 张倩[1] 杨杰[1] 

机构地区：[1]解放军第305医院心内科,北京100017

出　　处：《心脏杂志》2007年第5期587-589,共3页Chinese Heart Journal

摘　　要：目的观察尿激酶（UK）联合华发林治疗弥漫性严重冠脉病变的疗效及安全性。方法选择48例内科常规治疗包括硝酸酯、钙离子拮抗剂、β受体阻滞剂及低分子肝素等效果不佳的弥漫性严重冠脉病变患者，应用UK3．3～6．7mkat（1mkat=6×10^4U）加入生理盐水100ml中，于30min内输完，每日1次，连续应用7～10d，然后口服华法林，观察心绞痛的发生频率及程度、心电图ST段及心功能的变化。结果经过此种治疗方法与治疗前相比较，心绞痛的发生频率及程度减轻，心电图ST段及心功能改善。结论UK溶栓联合华发林抗凝治疗可使内科常规治疗效果不佳的弥漫性严重冠脉病变患者的心绞痛得到缓解。AIM To evaluate the clinical effect and safety of Urokinase（UK） in combination with Warfarin in treating serious coronary lesions. METHODS Forty-eight patients with serious coronary lesions were studied, who did not respond well to routine medications including isosorbide nitrate, 13-blocker, calcium channel blocker, anticoagulation and antiplatelet. Urokinase 3.3 - 6, 7 mkat（ 1 mkat = 60 000 U） was added to 100 ml normal saline and injected within 30 minutes once a day for 7 - 10 days and Warfarin was administrated after Urokinase applications. The frequency and severity of angina attack, STsegment elevation of ECG and cardiac function（NYHA） were observed. RESULTS After the combined treatment, the frequency and severity of angina attack alleviated, ST-segment elevation of ECG and cardiac function（ NYHA ） improved. CONCLUSION Thrombolytic therapy of low-dose Urokinase（UK） in combination with Warfarin alleviate angina in serious coronary lesions. This improved thrombolytic therapy can be used in patients who fail to respond well to routine medications.

关 键 词：冠状动脉疾病 尿激酶 溶栓疗法 老年人 

分 类 号：R541.4[医药卫生—心血管疾病] R973.2[医药卫生—内科学]