冠状动脉内重组链激酶溶栓对老年急性心肌梗死患者合并高血压安全性和有效性的初步探讨  

Preliminary study of intracoronary recombinant streptokinase(r-SK)in acute myocardial infaction with the risk of intracranial hemorrhage

作　　者：孟军[1] 山峰[1] 周长勇[1] 张锐[2] 

机构地区：[1]青岛医学院附属医院急诊部心脏病急救中心,266003 [2]青岛市第二人民医院心内科

出　　处：《中国介入心脏病学杂志》2000年第4期193-194,共2页Chinese Journal of Interventional Cardiology

摘　　要：目的　探讨冠状动脉内重组链激酶 (r SK)溶栓治疗老年急性心肌梗死 (AMI)患者合并高血压的有效性及安全性。方法　 99例AMI患者年龄均 >70岁 ,平均 (76 8± 5 5 )岁。其中低体重者 49例 (4 9 5 % ) ,溶栓前血压≥ 16 0 10 0mmHg(1mmHg=0 133kPa)者 5 9例 (5 9 6 % )。均接受冠状动脉内r SK溶栓治疗 :2～ 3min内冠状动脉内注入r SK 5万U ,继续以 5 0 0 0U min输入 90min ,总剂量为5 0万U ,遂行冠状动脉造影判断TIMI血流分级。结果　 90min冠状动脉开通率为 71 2 % ,其中TIMI3级达 47 9% ,TIMI 2级 31 1%。无一例颅内出血并发症。结论　本研究提示冠状动脉内r SK溶栓治疗老年AMI患者合并高血压安全、有效。Objective The study was designed to evaluate the safety and efficacy of intracoronary recombinant streptokinase (r SK) in the treatment of acute myocardial infaction (AMI) with risk of intracranial hemorrhage (ICH) Methods 99 patients with AMI were enrolled All the cases were over 70 years old, the body weight of 49 cases (49 5%) were less than 70 kg, 59 cases (59 6%) had hypertention more than 160/100 mm?Hg The r SK was administered by an introcoronary bolus of 5?000 U followered by infusion of 50?000 U over 90 min The primary endpoint was pentency grade (TIMI flow) of the infact related artery (IRA) by coronary angiography (CAG) at 90 min after initiation of treatment Results Coronary reperfusion rate was 71 2% by the 90 th minute CAG TIMI flow 3 was in 47 90%, TIMI 2 in 31 1% No bleeding incidence occurred Conclusion It is suggusted that intracoronary r SK is an effective and safe method for AMI with risk of ICH

关 键 词：心肌梗死 溶栓疗法 

分 类 号：R542.205[医药卫生—心血管疾病]