尿激酶静脉溶栓治疗急性心肌梗死的疗效和安全性

Therapeutic effect and safety of urokinase intravenous thrombolytic therapy in acute myocardial infarction

目的:分析尿激酶静脉溶栓治疗急性心肌梗死(AMI)的疗效和安全性。方法:选择我院收治的72例AMI患者,随机均分为常规治疗组和尿激酶组(常规治疗的基础上采用尿激酶静脉溶栓治疗),观察两组患者的治疗效果。结果:尿激酶组再通率明显高于常规治疗组(72.22%比27.78%,P<0.05),患者溶栓时间在2h内、3~6h、7~12h的再通率分别为77.78%、60.00%、50.00%,患者溶栓时间开始越早,患者再通率越高(P=0.032);与常规治疗组比较,尿激酶组治疗后肌酸激酶[(462.4±103.5)U/L比(621.2±113.5)U/L]、肌酸激酶同工酶[(37.5±21.3)U/L比(79.5±20.1)U/L]水平显著升高(P均<0.01);治疗5周后,与常规治疗组比较,尿激酶组不良反应发生率(33.33%比11.11%)显著降低(P<0.05)。结论:尿激酶静脉溶栓治疗急性心肌梗死溶通率高,病死率和并发症发生率较低,安全有效,值得临床推广使用。

Objective： To study the therapeutic effect and safety of urokinasc intravenous thrombolytic therapy in a- cute myocardial infarction （AMI）. Methods： A total of 72 AMI patients were selected in our hospital and randomly and equally divided into routine treatment group and urokinase group （received urokinase intravenous thrombolytic therapy based on routine treatment）, and then therapeutic effects were observed in two groups. Results： Recanaliza- tion rate of urokinase group was significantly higher than that of routine treatment group （72.22% vs. 27. 78%, P d0.05）. The recanalization rate for thrombolytic time in 2h, 3-6h and 7-12h were 77.78%, 60.00% and 50.00% respectively, the earlier thrombolysis started, the higher recanalization rate was （P = 0. 032）; compared with routine treatment group after treatment, there were significant rise in levels of creatine kinase [CK, （462.4± 103. 5） U/L vs. （621.2± 113.5） U/L] and CK isoenzyme [ （37. 5±20. 1） U/L vs. （79. 5±21.3） U/L] in uroki- nase group, P〈0.01 all; compared with routine treatment group on five-week after treatment, there were signifi- cant reductions in incidence rates of adverse reactions （33.33% vs. 11.11%） in urokinase group （P^0.05）. Conclusion： Urokinase intravenous thrombolytic therapy in acute myocardial infarction possesses high recanalization rate, lower mortality rate and incidence rate of complications, its effect and safety are high, which is worthy of clinical extension.