急性ST段抬高型心肌梗死采取L—Arg联合尿激酶方案的临床效果及不良反应探讨.docVIP

急性ST段抬高型心肌梗死采取L—Arg联合尿激酶方案的临床效果及不良反应探讨 　　[摘要] 目的 探讨急性ST段抬高型心梗采取尿激酶溶栓联合左旋精氨酸（L-Arg）治疗的临床疗效及安全性。方法 选取我院心内科2010年6月～2012年10月收治的120例急性ST段抬高型心肌梗死患者，随机分为研究组和对照组各60例。两组均采取常规溶栓治疗，研究组则在此基础上加用L-Arg。 结果 研究组在治疗后第6个月末的预后优于对照组（P 0.05），血管再闭塞率低于对照组（P 0.05），LVEF高于对照组（P 0.05），PAR低于对照组（P 0.05）。结论 对于急性ST段抬高型心肌梗死患者而言，采取尿激酶溶栓联合L-Arg，是一项有效、安全的治疗方案，值得进一步推广。 　　[关键词] ST段抬高型心梗；尿激酶；溶栓；左旋精氨酸 　　[中图分类号] R542.22 [文献标识码] B [文章编号] 1673-9701（2013）36-0037-02 　　Clinical efficacy and adverse effects of acute ST segment elevation myocardial infarction by L-Arg combined with urokinase 　　CHEN Zhi GAN Zhenxiong CHEN Xiaojun HUANG Liufang 　　Department of Cardiology， Huizhou City Huicheng District Small Jinkou Hospital in Guangdong Province，Huizhou 516023， China 　　[Abstract] Objective To explore the acute ST segment elevation myocardial infarction by urokinase combined with L-arginine （L-Arg） clinical efficacy and safety of treatment. Methods In our hospital from June 2010 to October 2012 120 patients with acute ST segment elevation myocardial infarction were elected， using random number table method for grouping.They were divided into study group and control group， each group had 60 cases. The two were taken to conventional therapy， study group based on the use of L-Arg. Results The study group after treatment in the sixth month， the prognosis was better than that of control group （P 0. 05）， vascular occlusion rate was lower than that of the control group（P 0. 05）， LVEF was higher than that of the control group（P 0.05）， PAR was lower than the control group （P0.05）. Conclusion Acute ST segment elevation myocardial infarction patients， taking urokinase combined with L-Arg， is an effective， safe treatment plan， worthy of further promotion. 　　[Key words] ST segment elevation myocardial infarction； Urokinase； Thrombolysis； L-arginine 　　急性ST段抬高型心肌梗死（STEMI，下称心梗）是心内科常见病[1]。该病主要是由于不稳定斑块的存在，一旦斑块破裂，会导致心内膜下胶原物质暴露[2]，大量血小板聚集形成血栓，进而引起冠脉血流中断，引发心前区疼痛。目前，在临床上针对该病的治疗以溶栓为主[3]，早期若实施科学、安全、合理的治疗能够有效降低患者死亡率，改善不良预后。但常规溶