早期应用低分子肝素对急性心肌梗死患者溶栓疗效影响.docVIP

早期应用低分子肝素对急性心肌梗死患者溶栓疗效影响作者单位：537700 广西陆川县人民医院 通讯作者：王杨光 【摘要】 目的 探讨对急性心肌梗死患者早期应用低分子肝素的治疗效果。方法 将120例急性心肌梗死患者随机分为对照组与观察组各60例，观察组于入院后溶栓治疗前30～60 min予低分子肝素5000 IU腹壁皮下注射，对照组于溶栓治疗开始后12 h给予低分子肝素5000IU腹壁皮下注射，对比两组再通及副反应情况。结果 观察组53例再通，再通率88.3%，对照组41例再通，再通率68.3%，两组比较差异有统计学意义（P0.05）。结论 溶栓治疗前早期应用低分子肝素对于提高急性心肌梗死患者血管再通率、缩短再通时间有积极意义，且疗效肯定，安全可靠。 【关键词】 早期； 低分子肝素； 急性心肌梗死 Effectiveness of early use of lowmolecular weight heparin calcium for thrombolytic therapy in patients with acute myocardial infarction WANG Yang-guang,HE Wen-wei,FENG min.The People’s Hospital of Luchuan, Luchuan 537000,China 【Abstract】 Objective To discuss the effectiveness of early use of low-molecular weight heparin（LMWH） for thrombolytic therapy in patients with acute myocardial infarction.Methods 120 patients with acute myocardial infarction were divided into the control group（60 patients） and the observation group（60 patients） randomly,the 60 patients in the observation group were injected 5000 IU LMWH before thrombolytic therapy and then received 1.5 million U urokinase after 30-60 minites,and the 60 patients in the control group received 1.5 million U urokinase first and then were injected 5000IU LMWH after 12 hours.We compared the revascularization rate for coronary artery and the bleeding risk between the two groups.Results 53 patients of the observation group reached the standard of revascularization for coronary artery,the revascularization rate was 88.3%,significantly higher than the control group（P0.05）.Conclusion Early application of low molecular weight heparin for acute myocardial infarction can improve the recanalization rates,shorten the recanalization time,and was more effective,safe and reliable. 【Key words】 Early； Lowmolecular weight heparin； Acute myocardial infarction 急性心肌梗死（Acute Myocardial Infarction,AMI）是心内科常见危急重症，近年来发病率有增高趋势。该病主要触发因素是冠状动脉内粥样硬化斑块破裂，引起血小板粘附聚集并活化，导致血栓形成。静脉溶栓治疗对本病的疗效是肯定的，溶栓抗凝药物通过释放和激活凝血酶可进一步活化血小板［1］，加之冠状动脉内壁的损伤仍然存在，且仍存在促凝物质，故患者难以避免再次梗死的发生［2］。既往认为早期肝素抗凝治疗可能导致出