不同剂量尿激酶治疗急性心肌梗死临床观察.docVIP

不同剂量尿激酶治疗急性心肌梗死临床观察 【关键词】nbsp; 心肌梗死；尿激酶；溶栓治疗；副作用 nbsp;nbsp;nbsp;nbsp;nbsp;nbsp; ［摘要］nbsp; 目的nbsp; 了解不同剂量尿激酶(UK)静脉滴注对急性心肌梗死(AMI)患者的疗效和出血并发症发生情况。方法nbsp; 61例AMI患者符合WHO的AMI诊断标准，无溶栓禁忌证，随机分成小剂量溶栓组和大剂量溶栓组。小剂量溶栓组31例，以60万u UK溶于5%葡萄糖液100 ml 溶液中30 min内静滴完；大剂量溶栓组30例，以150万u UK溶于5%葡萄糖100 ml溶液中30 min内静滴完；其他基础治疗两组相同。每组患者溶栓开始3 h内每30 min检查一次心电图，以后定期检查；溶栓开始至起病24 h内每2 h一次血清 CK、CK－MB，起病48 h测定最后一次。 观察心率、心律、血压、胸痛变化和呕吐物、痰液、大小便、皮肤、黏膜的出血征象。nbsp; 结果nbsp; 小剂量溶栓组出血并发症为3.23%，低于大剂量溶栓组的20%，经比较分析差异有显著性(P＜0.05)，其中两组消化道出血、血痰、血尿发生率之和的比较P＜0.05。两组血管再通率、再梗死率、严重并发症发生率、病死率相近,差异均无显著性(P＞0.05)。结论nbsp; 以60万u尿激酶静滴法治疗AMI出血并发症尤其脏器出血的发生率明显降低，疗效可靠，更加安全。 nbsp;nbsp;nbsp; ［关键词］nbsp; 心肌梗死；尿激酶；溶栓治疗；副作用 nbsp;nbsp;nbsp;nbsp; Clinical trial ofnbsp; different doses of urokinase in patients with acute myocardial infarction nbsp;nbsp;nbsp;nbsp; ［Abstract］nbsp; Objectivenbsp; To investigate the effects and adverse bleeding actions of different doses with intravenous urokinase in acute myocardial infarction.Methodsnbsp; 61 cases of acute myocardial infarction were divided randomly into two groups, 31 cases in two dose group with intravenous urokinase 60?04 u in 5% glucose 100 ml in 30 minutes and 30 cases in high dose group with intravenous urokinase 150?04 u in 5% glucose 100 ml in 30 minutes. Other treatment in patients of the two groups were correspondence. Recorded the electrocardiogram of all patients per 30 minute after treatment in three hours, then was recorded it at time. Began with thrombolytic therapy after the onset of acute myocardial infarction for 24 hours, tested for serum CK and CK－MB per 2 hour, the last test of serum CK and CK－MB was did after illness for 48 hours. Measured the heart rate，the rhythm of the heart beating， the blood pressure and asked for the pain in the chest，and surveyed adverse bleeding actions of the vornitus， the phlegm， the stool，the urine， the skin， the mucous membrane of the patients. Resultsnbsp;nbsp; Adverse bleeding action rates were 3.23% in low dos