摘要
目的：用国产尿激酶经冠脉内溶栓，观察对急性心肌梗塞（ＡＭＩ）的疗效．方法：患者３２（男３０，女２）例，年龄５４．８±１１．９（２９～８２）岁．心绞痛发病后２．５～１２ｈ，经ＥＣＧ证实ＡＭＩ，并作选择性冠脉造影确诊梗阻部位，给０．５ｇ硝基甘油以排除血管痉挛，经导管内注入国产尿激酶２００～２５０ｋＵ以５～８ｋＵ／ｍｉｎ之速度进行溶栓治疗，观察１５ｍｉｎ后再作冠脉造影观察疗效，如未溶开可重复给尿激酶２～３次．结果：冠脉内溶栓后经造影显示血栓使血管完全闭塞者２１例（６５．６％），其中ＬＡＤ支１１例；Ｄ１支１例；ＬＣＸ支３例；ＲＣＡ支６例．部分性闭塞者１１例（３４．４％），其中ＬＡＤ支７例；ＲＣＡ支４例．溶栓后有效率２７例（８４．４％）．ＥＣＧ示抬高ＳＴ段下降．５例未溶开（１５．６％）．结论：ＡＭＩ经冠脉内用国产尿激酶进行溶栓治疗，有效率为８４．４％．仅１５．６％未溶开．
Objective: To report the postthrombolytic angiographic manifestations of evolving acute myocardial infarction (AMI) treated by China made urokinase. Methods: Thirty two patients (males 30, females 2), 29～82 years of age (average 54.8±11.9 years), were admitted 2.5～12 h after an angina attack. ECG on admission showed infarction somewhere in the myocardium. Selective coronary angiography was performed to detect the exact site of obstruction. Then the catheter was passed furthermost till its tip reached the block and nitroglycerine 0.5 mg was given to prevent vasospasm. To dissolve the thrombus, urokinase 5～8 kU/min was given by intravenous drip. If necessary, the administration was repeated 2 to 3 times with a total of 200～250 kU at most. Fifteen minutes later, coronary angiography was repeated to see whether the vessel was recanalized. Results: Before thrombolysis coronary angiography showed total block occurred in 21 cases (56.6%) including LAD 11 cases, D 1 1 case, LCX 3 cases and RCA 6 cases, partial stenosis was found in 11 cases (34.4%) consisting of LAD 7 cases and RCA 4 cases. After thrombolysis 27 cases (84.4%) got relief of symptoms and recovered from ECG abnormalities, but the thrombus failed to dissolve in 5 cases (15.6%). Conclusion: In the treatment of acute myocardial infarction intracoronary injection of China made urokinase given satisfactory results in 84.4% cases of this series. Only 15.6% of cases did not give way to this procedure.
出处
《第四军医大学学报》
1996年第5期353-355,共3页
Journal of the Fourth Military Medical University
关键词
心肌梗塞
急性
冠状动脉
溶栓术
myocardial infarction, acute coronary thrombosis coronary angiography
