大剂量静脉输注尿激酶治疗急性心肌梗塞的初步观察  

High Dose Intravenous Urokinase Infusion in Treatment of Acute Myocardial Infarction

作　　者：赵文鼎[1] 张承宗[1] 王林[1] 李志坚[1] 黄体钢[1] 

机构地区：[1]天津医学院第二附属医院心脏科

出　　处：《天津医药》1991年第12期714-717,共4页Tianjin Medical Journal

摘　　要：19名急性心肌梗塞患者静脉滴注尿激酶150～200万 U,根据心电图在溶栓后2小时内恢复稳定状态、肌酸磷酸激酶峰值提前和再灌注心律失常判断,冠脉再通率53%,溶栓后出现的室性心律失常,有可能发展为室颤,需用抗心律失常药物治疗。溶栓早期出现的加速性室性自搏律,是再灌注的可靠指征,不发展为室颤。溶栓后63%患者出现恶心、呕吐。未见严重出血并发症。Nineteen patients with acute myocardial infarction(AMI)treated with intrave-nous urokinase were studsed.An intravencus infusion of the dose of 1.5-2.0 millionunit of urokinase was administered in 45±15 minutes.Reperfusion rates were foundin 53% of patients,based on the criteria of elevated ST segment returned to stablestatus in ECG within 2 hours,early occurring of the peak of creatine kinase acti-vity and the prevalence of arrhythmias occurring after thrombolytic therapy.Theappearance of ventricular arrhythmia after thrombolytic therapy may degenerateinto ventricular fibrillation and antiarrhythmia therapy is needed.However,theaccelerated idioventricular rhythm during the early phase of AMI is a reliable signof reperfusion and will not degenerate into ventricular fibrillation.During intravenous urokinase infusion nausea and vomiting were found in 63%of patients.No serious hemorrhagic complications were found in the series.

关 键 词：急性 心肌梗塞 尿激酶 溶栓治疗 

分 类 号：R542.22[医药卫生—心血管疾病]