100例急性心肌梗塞静脉给予不同剂量尿激酶的应用研究

A Clinical Study of Intravenous Urokinase at Various Doses in Treating 100 Cases of AMI

1980～1990年,我们摸索了尿激酶静脉治疗急性心肌梗塞的剂量。第一期:小剂量组36人,胸痛缓解治疗组比对照组为75.0％对16.7％,抬高的ST段比原来下降50.0％对8.0％,FDP升高94.4％。第二期:试用大剂量组12人,此期再分为两个亚组:较大剂量组7人(>80万U),较小剂量组5人(<30万U)。较大剂量组3人符合明确再通标准(42.9％),但2人发生心脏破裂,可能与再灌注损伤有关;较小剂量组无人达再通指标。第三期;综合剂量组52人,都有对照组,根据不同发病时闻给予大中小三种剂量,死亡率最低,疗效显著。对UK的除溶栓和改善血液粘稠度作用进行了讨论。

From 1980 to 1990 we have treated 100 cases of AMI with i. v. Urpkinase. According to the way of management and the dosage administered, they were divided into three stages: stage I of small dosage, 36 patients, stage I of trial big dosage, 12 patients and stage I of comprehensive dosage, 52 patients. In stage I 75.0% in the treated group only 16.7% in the control group obtained relief from pain.Decrease of elevated ST reaching base line was 50.0% vs 8.0%,and FDP increased in 94.4%. In stage I ,they were subdivided in to larger dose( more than 800 000 U) and smaller dose (less than 300 000 U) groups. From the larger dosage group 3 patients showed definite sign of recanalization but unexpectedly 2 patients died of cardiac rupture. The recanalization rate of larger dose group was 42.9%, but no case showed any sign of rtcanalization in smaller dose group. Cardiac rupture was thought to be mostly due to reperfusion injury. Thus we desinged a 3rd stage of comprehensive dosage of UK. In this stage based on the different time of onset we used different doses of UK and different routesi of administration in 52 patients, so as to brng the effect of UK in to full play. The aim of using UK is chiefly to make use of its fibrinolytic function as well as to improve the blood viscosity. In this stage the benefical effects of UK may be achieved in different ways. Relief of pain and decline of ST segment were significantly prominent in all three groups in comparison with the control group.