早期应用低分子肝素在急性心肌梗死患者溶栓治疗中的疗效观察(1)
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[摘要] 目的：探讨早期应用低分子肝素在急性心肌梗死患者溶栓治疗中的效果。方法：将我院收治的80例急性心肌梗死患者随机分为两组，观察组于入院后溶栓治疗前30～60 min予低分子肝素5 000 IU腹壁皮下注射，对照组于溶栓治疗后6 h给予低分子肝素5 000 IU腹壁皮下注射，对比两组冠脉再通及不良反应情况。结果：观察组冠脉再通率为85%，对照组再通率为65%，两组比较差异有统计学意义(P<0.05)；观察组再通时间为(1.50±0.71)h，对照组为(2.10±0.92)h，差异有统计学意义(P<0.05)；两组出血发生率比较差异无统计学意义(P>0.05)。结论：溶栓治疗前早期应用低分子肝素治疗对于提高急性心肌梗死患者冠脉再通率、缩短再通时间有积极意义，且安全性良好。
[关键词] 早期；低分子肝素；急性心肌梗死
[中图分类号] R542.22 [文献标识码] A [文章编号] 1673-7210(2012)01(a)-074-02
Effect of early use of low-molecular weight Heparin for thrombolytic therapy in patients with acute myocardial infarction
QI Wei
Department of Intensive Care Unit, Aerospace Hospital, Hu'nan Province, Changsha 410205, China
[Abstract] Objective: To explore the effect of early use of low-molecular weight Heparin (LMWH) for thrombolytic therapy in patients with acute myocardial infarction (AMI). Methods: 80 patients with AMI were randomly divided into two groups, the 40 patients in the observation group were injected LMWH 5 000 IU and then were given Urokinase after 30-60 minutes of thrombolytic therapy, and the other 40 patients in the control group were given thrombolytic therapy first, and then injected LMWH 5 000 IU after 6 hours. The revascularization rate of coronary artery and the bleeding risk between the two groups were compared. Results: The revascularization rate in the observation group was significantly higher than that in the control group (85% vs 65%) (P<0.05). The revascularization time in the observation group [(1.50±0.71) h] was significantly shorter than that in the control group [(2.10±0.92) h] (P<0.05). The bleeding risk between the two groups had no significant difference (P>0.05). Conclusion: Early application of LMWH in AMI can improve the rates of recanalization, shorten the time of recanalization, this method is effective and safety.
[Key words] Early; Low-molecular weight Heparin; Acute myocardial infarction
急性心肌梗死(acute myocardial infarction，AMI)是指因冠状动脉急性闭塞引起心肌供血障碍，导致局部心肌缺血性坏死。冠状动脉粥样硬化斑块破裂，血小板黏附、聚集、活化，继而血栓形成是AMI的主要触发因素。静脉溶栓后应用低分子肝素(LMWH)辅助抗凝治疗目前在临床上应用广泛 ......
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