尿激酶溶栓治疗急性心肌梗死疗效观察

Therapeutic effect of thrombolytic therapy with urokinase on acute myocardial infarction

目的判断尿激酶静脉溶栓治疗急性心肌梗死(AMI)的疗效。方法回顾分析我科1997年2月-2005年2月应用尿激酶(150万u,30 min内静滴)治疗69例AMI患者的临床症状、心电图、心肌酶谱的变化及不良反应,根据冠脉再通间接指征判断冠脉再通率。结果冠脉再通率达到73.9%,69例患者溶栓后早期(24h内)T波倒置49例,其中冠脉再通43例,早期T波未倒置20例中冠脉再通8例。结论AMI患者早期使用尿激酶静脉溶栓安全可靠,疗效满意,溶栓后早期T波倒置对判定冠脉再通有重要价值。

Objective To observe the therapeutic effect of venous thromholytic therapy with urokinase on acute myocardial infarction （AMI）. Methods Sixty-nine cases were treated by venous thrombolytic therapy with urokinase （1 500 were reviewed and including thousand unit, iv drop within 30 min） the clinical symptoms, ECG, CK, CK-MB and adverse effect were reviewed. The repatency of the coronary artery was evaluated by indirect indicators. Results The repatency rate of the coronary artery was 73.9 %. Forty-nine patients had T-wave inversion within 24 h after the treatment, and forty-three cases of them had repatency; Twenty patients didn＇t have T-wave inversion, and eight cases of them had repatency. Conclusion Early venous thrombolytic therapy with urokinase has good therapeutic effect on AMI, and after the thrombolytic therapy, early T-wave inversion was the better predictor for the repatency of the coronary artery.