纳络酮与尿激酶联合治疗急性心肌梗死临床观察

The Study of Clinical Effect of Naloxone and Urokinase in the Treatment of Acute Myocardial Infarction Patients

目的探讨纳络酮与尿激酶联合治疗急性心肌梗死(AMI)的临床疗效。方法将112例 ST 段抬高的 AMI 患者随机分成络酮组(58例)和对照组(54例)。对照组应用尿激酶(UK)150万 u 溶于生理盐水100 ml 中静滴,30 min 滴完。纳络酮组在溶栓前给以纳络酮2 mg 静脉推注,然后以0.01 mg/(kg·min)速度持续静脉泵注,溶栓方法同对照组。各组在溶栓前常规记录18导联心电图,查血常规、血小板、出凝血时间、心肌酶,观察胸痛缓解时间,血清 CPK 峰值提前时间,比较两组再通情况和不良反应出现情况。结果纳络酮组再通成功率明显高于对照组(P<0.001),纳络酮组副作用发生率明显低于对照组(P<0.05)。对照组死亡3例,纳络酮组无死亡者。结论纳络酮可提高 ST 段抬高的 AMI 患者溶栓再通成功率,减少溶栓后并发症的发生。纳络酮在 ST 段抬高的 AMI 患者的溶栓治疗中起着比较重要的作用。

Objective To investigate clinical effect of naloxone and urokinase in the treatment of acute myocardial infarction（AMI） patients. Methods It is used by advanced disquisitive method ,the AMI patients whose ST segment elevated in EKG, were randomized divid- ed into control group（54 cases） and naloxone group 58 cases. Urokinase 1 500 000 u by intravenous injection in every group,but in naloxone group naloxone 0. 01 mg/（ kg · min） by intravenous injection were added before dissolving the thrombus. Results Recovery ratio were significantly higher in naloxone group than in control group （ P 〈 0. 01 ）. Side effect were also significantly lower in naloxone than in control group （ P 〈 0. 05 ）. There were 3 cases died in control group, but no motality in naloxone group. ConclUsion Naloxone might increase of recovery ratio in the AMI patients with ST segment elevated,decreased complications,and might decreased mortality rate. It is one of the best and most effective measure to treat the AMI patients with ST segment elevated in EKG.