肝素加尿激酶对急性心肌梗死疗效观察.docVIP

肝素加尿激酶对急性心肌梗死疗效观察 　　[摘要] 目的:评价肝素的使用时机对急性心肌梗死再灌注的影响。方法:收治住院符合ST段抬高的急性心肌梗死溶栓标准的患者66例,将其分为观察组33例和对照组33例。均给予尿激酶1 500 000 U加入100 ml0.9%氯化钠溶液中,于30 min内静脉输注溶栓。观察组于溶栓前即刻给予普通肝素5 000 U静推。结果:观察组尿激酶溶栓后再通率为87.88%,对照组溶栓后再通率为66.67%,两者比较,差异有统计学意义(P0.05)。结论:尿激酶溶栓前即刻静脉输注肝素能显著提高冠状动脉血管再通率,改善患者预后,不会增加临床出血的危险。 　　[关键词] 急性心肌梗死;再灌注;肝素 　　[中图分类号] R972+.9 [文献标识码]B [文章编号]1674-4721(2010)03(a)-054-02 　　 　　The efficiency of the heparin plus urokinase in acute myocardial infarction 　　WANG Naizhe1,WANG Hongzhe2 　　(1.Department of Cardiovasular Medicine, the Peoples Hospital of Lushan County, Henan Province, Lushan 467300, China;2.Department of Medicine, the First Peoples Hospital of Xuchang City, Henan Provtnce, Xuchang 461000,China) 　　[Abstract] Objective: To evaluate the effects of the use of timing of heparin in acute myocardial infarction reperfusion.Methods: Patients treated in line with ST-segment elevation acute myocardial infarction cases of the standard,66 cases were divided into 33 cases of the observation group and the control group of 33 cases. 1 500 000 U of urokinase were given by adding 100 ml normal saline in 30 minutes intravenous infusion thrombolysis.Immediately before the observation group was given thrombolytic therapy given 5 000 U unfractionated heparin bolus. Results: The group of urokinase patency rate was 87.88%,the control group pass rate was 66.67%. After comparision, the difference was significant(P0.05). Conclusion: Immediately before thrombolysis by intravenous infusion of heparin significantly increase the rate of coronary artery recanalization and improve the prognosis of patients, not to increase the clinical risk of bleeding. 　　[Key words] Acute myocardial infarction; Reperfusion; Heparin 　　 　　急性心肌梗死是威胁人类生命的急症、重症,早期开通罪犯血管,能明显降低死亡率,目前静脉溶栓疗法是恢复早期再灌注的最经济、最简单的首选方法。笔者对尿激酶溶栓前使用肝素,取得满意的效果。现将2007年9月～2009年11月住院溶栓后抗凝治疗的ST段抬高的急性心肌梗死患者66例予以总结分析,以确定其疗效及安全性。 　　1 资料与方法 　　1.1 一般资料 　　选自2007年9月～2009年11月住院的66例ST段抬高的急性心肌梗死患者,符合WHO的诊断标准并接受溶栓治疗,发病均在6 h以内,无相关溶栓禁忌证。随机将其分为观察