急性心肌梗死早期静脉溶栓治疗的临床价值

The clinic value of forepart thrombolytic therapy via vein in the patients with acute myocardial infarction

目的探讨尿激酶早期静脉溶栓治疗急性心肌梗死(AMI)的临床价值。方法回顾性分析21例AMI静脉溶栓病例,根据急性心肌梗死溶栓疗法参考方案[1]制订的再通标准计算梗死相关血管(IRA)的再通率及观察溶栓并发症、病死率。结果本组静脉溶栓再通率为80.9%,合并轻度消化道出血3例。住院期间5周病死率为9.5%,死亡2例均并发心源性休克且为溶栓未通的大面积心肌梗死重症患者。有6例年龄>75岁(最大者87岁)的患者溶栓再通,且无出血反应,取得了满意的疗效。结论尿激酶早期静脉溶栓治疗AMI再通率高、不良反应小、疗效可靠,且操作简便、适合基层医院推广使用。

Objective To discuss the clinic value of forepart thrombolytic therapy with drugs（urokinase）via vein in the patients with acute myocardial infarction（AMI）.Methods 21 cases with AMI from October 2005 to February 2007 were analyzed retrospectively,recanalization rate and fatality rate of infarction relation artery were counted according as clinical recanalization indexe of thrombolytic therapy,simultaneity complications were observed.Results The recanalization rate was 80.9%and the fatality rate was 9.5%,3 cases combined gently alimentary canal bleeding in all,2 cases of death equal combined cardiac shock just were large acreage infarction with failed recanalization.6 cases of elderly patients（〉75 years old,the eldest patient was 87 years old）also acquired satisfying curative effect of recanalization,without alimentary canal bleeding.Conclusion Thrombolytic therapy with drugs（urokinase）via vein in AMI is an important treatment with high recanalization rate,less side-effect,credible curative effect even convenient operation,which adapts to spreading in grass-roots hospital.