尿激酶溶栓治疗时间对急性心肌梗死患者左心室收缩功能影响.doc

尿激酶溶栓治疗时间对急性心肌梗死患者左心室收缩功能影响[摘要] 目的 探讨尿激酶溶栓治疗急性心肌梗死患者的启动时间及用药后对患者左心室收缩功能的影响。方法 选择我科收治的急性心肌梗死患者60例，按照尿激酶溶栓治疗的不同启动时间（3 、6 、12h）分为三组各20例 。于发病后第7天采用心脏超声检测患者的左心室收缩功能并进行比较。 结果 三组溶栓人数比较差异有统计学意义（P＜0.05）。3 h溶栓组的左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、室间隔收缩幅度(LVPWae)、左心室后壁收缩幅度（IVSae）均明显高于另外两组，三组间以上指标比较有显著差异（P＜0.05）。结论 急性心肌梗死患者应于发病3 h内行尿激酶溶栓治疗，此时间内用药可明显改善患者的左心室收缩功能。 [关键词] 急性心肌梗死；尿激酶；溶栓；左心室 [中图分类号] R542.22 [文献标识码] B [文章编号]1673-9701（2011） 31-51-02 Effect of Urokinase Thrombolysis Start time on Left Ventricular Systolic Function in Patients with Acute Myocardial Infarction YU Baojun WANG Liwei YU Xiaoming Emergency Department, the People’s Hospital of Xinchang County, Xinchang 312500, China [Abstract] Objective To explore the effects of urokinase thrombolysis start time on left ventricular systolic function in patients with acute myocardial infarction. Methods Selected 60 patients with acute myocardial infarction, divided them by Start time of urokinase Thrombolysis (3h,6h,12h) into 3 groups, 20 patients in each group. On 7th day after invasion, test left ventricular systolic function through cardiac ultrasonography and make comparision. Results Comparative difference of 3 groups data, There was statistically significant（P＜0.05）. LVEF of 3h group，LVFS，LVPWae，IVSae was obviously higher than other 2 groups, index above among 3 groups was different（P＜0.05） . Conclusion Patients with acute myocardial infarction should receive treatment of urokinase thrombolysis within 3h after invasion, ventricular systolic function can be improved by medication. [Key words] Acute myocardial infarction；Urokinase；Thrombolysis；Left ventricle 急性心肌梗死(acute myocardial infarction，AMI)是指因持久而严重的心肌缺血所致的部分心肌急性坏死。临床主要表现为持久的胸骨后剧烈疼痛、心律失常、心功能衰竭、体温升高、白细胞数增多、血清心肌酶谱升高等表现[1]。对急性心肌梗死实施及时的救治至关重要，本文回顾性分析我科收治的50例急性心肌梗死患者的溶栓治疗资料，探讨理想的治疗时机，现报道如下。 1 资料与方法 1.1 一般资料 选择我院2009年1月～2010年12月急诊收治的急性心肌梗死患者60例，其中男25例，女35例，年龄(52.18±8.47)岁。其中前间壁梗死患者24例，广泛前壁梗死患者26例，下壁梗死患者10例。所有患者均符合中华心血管病学会制定的急性心肌梗死诊断标准[2]。入急诊后均行静