摘要
目的：探讨尿激酶（ Ｕ Ｋ）不同剂量、发病后不同时间溶栓对急性心肌梗死（ Ａ Ｍ Ｉ）的疗效。方法：２８１例 Ａ Ｍ Ｉ患者按 Ｕ Ｋ 剂量分成１００万ｕ、１５０万ｕ、２００万ｕ 组，按发病时间分成≤２ ｈ、＞ ２～４ｈ、＞ ４～６ ｈ、＞ ６～１２ ｈ 四个时间段。结果：３组的疗效无显著性差异（ Ｐ ＞ ０．０５），而轻度出血１００万ｕ 组低于２００万ｕ 组（ Ｐ ＜ ０．０５），且未发生重度出血及脑出血；虽血管再通率≤２ ｈ 与＞ ６～１２ ｈ 有高度显著性差异（ Ｐ ＜ ０．０１），但病死率及安全性在不同时间差异不明显（均 Ｐ ＞ ０．０５）；６ ｈ 内溶栓各剂量组再通率相近，而延迟溶栓（＞ ６～１２ ｈ）各剂量组再通率有较大差别（随剂量加大而升高）。结论： Ｕ Ｋ １００万ｕ 是安全有效的剂量，特别是对发病６ ｈ 内溶栓者；延迟溶栓仍有较大价值，并似可加大 Ｕ Ｋ 剂量以提高再通率。
Objective:To assess the efficacies of intravenous urokinase (UK) indiffent starting time of thrombolysis after onset of acute myocardial infarction (AMI) ,and explore its relationship with different dose of UK.Method:281 patients of AMI were treated with UK According to the different dose of Uk,281 cases were divided into 1.0 million U, 1.5 million U and 2.0 million U groups.The patients were also divided into≤2 hour, 2.1 ～4 hour, 4.1 ~6 hour and 6.1 ~12 hour groups,according to the different starting time of treating AMI.Result:The total patency rate of infarct related coronary arteries within 3 hours (including delayed patency) was 66.9 by clinical evidences of reperfusion and mortality in the first 5 weeks was 8.9 %.The efficacy of 1.0 million group was similar to 1.5 and 2.0 milion groups (all P> 0.05 ),while the rate of minor bleeding was higher (P< 0.05 ) in 2.0 million group than in 1.0 million group,the major bleeding occurred in 1.5 (1 case) and 2.0 million (1 case) groups,and 2 cases of intracranial hemorrhage occurred in 2.0 million group,too.The reperfusion rate was decreased as the thrombolysis was delayed, 79.2 % in ≤2 hour group and 54.0 % in 6.1 ~12 hour group (P< 0.01 ).However there was no significant difference of mortality and safety in all groups with different starting time (all P> 0.05 ).In addition,the patency rates of thrombolysis within 6 hours after onset had not difference in 3 doses groups,wheras the ones of delayed thrombolysis ( 6.1 ~12 hours) had major difference (respectively, 42.9 %, 57.1 % and 62.5 %),but no statistical significance (all P> 0.05 ).Conclusion:Intravenous UK 1.0 million U for AMI is effective and safer, especially in the patients treated within 6 hours; delayed thrombolysis has still major value, and its patency rate may be raised by increasing dose of UK.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
1999年第8期352-354,共3页
Journal of Clinical Cardiology
关键词
心肌梗塞
尿激酶
溶栓疗法
静脉溶栓
Myocardial infarction Thrombolytic therapy Urokinase
