尿激酶联合肝素静脉溶栓治疗急性心肌梗死的临床疗效观察(1)
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[摘要] 目的 探讨尿激酶联合肝素静脉溶栓治疗急性心肌梗死的疗效价值。 方法 选取我院符合急性心肌梗死溶栓标准的患者66例，分为实验组和对照组各33例。实验组于溶栓前给予低分子肝素5000 U静推，随后两组均给予尿激酶150万U加入100 mL0.9%氯化钠溶液中，于30 min内静脉输注溶栓。 结果 两组CK、CK-MB水平较治疗前明显下降，但实验组明显低于同期对照组治疗水平。实验组总有效率84.85%高于对照组72.73%，两组差异有统计学意义(P<0.05)。 结论 尿激酶联用低分子肝素静脉溶栓治疗急性心肌梗死的方法安全有效， 应用较方便，值得在临床推广。
[关键词] 尿激酶；肝素；静脉溶栓；急性心肌梗死
[中图分类号] R542.22 [文献标识码] B [文章编号] 1673-9701(2012)02-0062-02
The clinical efficiency study of urokinaes and heparin intravenous thrombolytic therapy for acute myocardial infarction
ZHANG Zhongming
Cardiology Department of Wenzhou Hospital of Integrated Traditional and Western Medicine, Wenzhou 325000, China
[Abstract] Objective To study the value of the intravenous thrombolysis with urokinase and heparin treatment for acute myocardial infarction. Methods All 66 cases of acute myocardial infarction were divided into the experimental group and the control group. Before given thrombolytic therapy, the experimental group was given 5000 U heparin bolus. Then 1500 000 U of urokinase were given in two groups by adding 100 mL normal saline in 30 minutes intravenous infusion thrombolysis. Results CK, CK-MB levels in both groups decreased, which was lower in the experimental group than the level in the control group. The experimental group owned a total effective rate of 84.85%, higher than that of the control group 72.73%. All difference was statistically significant (P<0.05). Conclusion It is safe and efficient to use urokinaes and LMWH for intravenous thrombolytic therapy in patients with AMI, which deserves to be popularized in practice.
[Key words] Urokinase; Heparin; Intravenous Thrombolysis; Acute myocardial infarction
急性心肌梗死(AMI)是心内科的常见病，梗阻发生时，冠状动脉堵塞的时间越长，心肌损伤就会越广泛。因此，及时准确地作出诊断并给予积极合理的治疗是降低急性期死亡率、改善长期预后的关键[1]。研究表明实施静脉溶栓治疗，不仅能够阻止心肌梗死的发展，还能显著改善患者的预后[2]。本院2008年3月～2010年12月对66例AMI患者采用尿激酶联合肝素进行静脉溶栓治疗，取得了良好的效果，现将结果报道如下。
1 资料与方法
1.1 一般资料
选取本院2008年3月～2010年12月收治的AMI患者66例。其中男41例，女25例，年龄38～75岁，平均54.8岁。将患者随机分为实验组和对照组各33例，两组患者在性别、年龄、病变程度等情况经统计学处理后，差异无统计学意义(P>0.05)。
病例纳入标准[3]：①典型持续性胸痛时间超过30 min且舌下含硝酸甘油不缓解；②心电图至少2个或以上相邻导联ST段抬高≥1.0 mV；③发病时间6 h内；④年龄不大于75岁；⑤除外溶栓禁忌证。
1.2 治疗方法
两组患者治疗前均接受常规心电监护 ......
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