应用尿激酶溶栓治疗心肌梗死142例临床分析  

Clinical analysis of 142 patients with acute myocardial infarction treated by the intravenous thrombolytic therapy

作　　者：高秀华[1] 李晓佳[1] 苏德兴[1] 

机构地区：[1]章丘市人民医院,山东章丘250200

出　　处：《杭州医学高等专科学校学报》2001年第3期143-144,共2页Journal of Hangzhou Medical College

摘　　要：目的　探讨对急性心肌梗死 (acutemyocardialinfarction ,AMI)进行早期溶栓治疗的疗效。 方法　本组142例均符合AMI溶栓的适应证 ,无禁忌证。患者入选后立即嚼服阿斯匹林 30 0mg ,以后每日 (10 0～ 15 0 )mg ;尿激酶 (urokinase,UK) 2 2 0 0 0IU/kg半小时内静脉滴入 ,UK滴完后 6～ 12h皮下注射肝素 75 0 0 U,每 12h一次 ,持续 3～ 5d。结果　 142例中 ,再通 87例 (6 1 3% ) ,未通 5 5例 (38 7% )。发病至开始溶栓时间≤ 2h、2～ 4h、4～ 6h者再通率分别为 74 4%、6 7 3%和 43 6 % ,4h后的再通率明显低于 4h以内的再通率 (P <0 0 5或P <0 0 1)。结论　早期溶栓治疗可以缩小梗死范围 ,保护心脏功能 ,降低病死率 ,减少并发症。Objective To investigate the effect of the intravenous thrombolytic therapy on acute myocardial infarction (AMI).Method 142 patients with AMI were appropriate candidates for early intravenous thrombolytic therapy without any contra indications.All patients took aspirin 300mg(the first dose)by chawing at first and then took 100-150mg per day.Urokinase(UK,22 000IU/kg)was given by intravenous dropping within half an hour.6～12 hours later after UK was given,7 500u heparin was given subcutaneously per 12 hours,which lasted 3 to 5 days.Rcsult The 87 cases (61 3%)of infarct related arteries were reopened and 55 cases(38 7%)were still blocked.The reopening rates of infarct related arteries that were treated by thrombolysis no more than 2 hours,within 2 to 4 hours or within 4 to 6 hours after AMI occurred were respectively 74 4%,67 1%and 43 6%.The reopening rate of infarct related arteries that were treated by thrombolysis later than 4 hours was significantly lower than within 4 hours.Conclusion The early intravenous thrombolytic therapy in AMI could decrease the infarct areas,protect the heart function,and reduce the mortality and complications.The rate of reopening was closely relative to the time when the thrombolysis began.

关 键 词：心肌梗死 尿激酶 血栓溶解治疗 AMI 

分 类 号：R542.22[医药卫生—心血管疾病]