尿激酶不同静脉给药方式治疗急性心肌梗塞对比研究

A comparative study of different modes of iutravenous urokinase administration in acute myocardial infarction

比较尿激酶不同静脉络药方式对急性心肌梗塞（AMI）的作用。41例AMI患者随机一次静脉推注尿激酶（UK）100～150万U（甲组：20例）或半量（50～75万U）静脉推注加半量（50～75万U）静脉滴注（乙组：21例）。于治疗后90分钟行冠状动豚造影观察梗塞相关冠状动脉（IRA）前向血流情况，并记录两组住院期心脏事件、左心室功能及不良反应。两种治疗方式90分钟总IRA再通率为51．2％（21／41）。其中甲组为55％（11/2n）；乙组为4入6％（1I/21）（P＞0.05）。两组左心室功能差异天显著性。甲、乙两级死于秦衰竭分别1、2例，且住院期心脏事件发生率无明显差异。两种方法的出血和低血压不良反应均少见。尿激酶100～150万U两种静脉给药方法治疗AMI对冠状动脉再通车及住院期临床预后的影响差异不大。

To assess the effects of different modes of intravenous urokinase administration on infarct-related artery (IRA) patency and in-hospital outcomes in acute myocardial infarction (AMI). Fourty-one patients with AMI hospitalized within 12 hours were randomized to receive either bolus intravenous injection with urokinase of 1-1.5 million unit (group 1; 20 cases) or half does (0.05-0. 75 million unit)bolus intravenous injection plus another half dose intravenous infusion within 30 minutes (Group -Ⅱ; 21 ca-ses). The coronary angiography was performed 90 minutes later to observe the antegrad flow status of IRA Cardiac events during hospitalization were recorded and predischarge left ventricular function was assesed by echocardio graphy. The adverse effects were also evaluated. For the two groups,the overall IRA patency was 51. 2%. The IRA patency was not significantly different between group Ⅰ(55%) and group Ⅱ(47. 6% ) (P>0.05). Predischarge echocardiographic examination showed left ventricular end diastolic and end systolic volumes and ejection fraction were similar in the two groups. There were 1 and 2 deaths in group Ⅰ and group Ⅱ due to pump failure,but the total cardiac event rate did not differ,and incidence of bleeding and hypotension was low. There are no differences in angiographc and clinical outcomes between these two intravenous urokinase administration.