摘要
目的 :为探讨急性心肌梗死 (AMI)用国产尿激酶 (天普洛欣 )进行静脉溶栓治疗时不同剂量特别是个体化大剂量给药的疗效及出血副作用 ,并探讨大于 3万 IU/ kg(最高 30 0万 IU)使用的安全性。方法 :将入选发病 12 h内个别 2 4h内的 16 2例患者随机分 3组 :A组即低剂量组 (5 0万 IU) 32例 ,B组即中剂量组 (15 0万 IU) 38例 ,C组即个体化大剂量组(>3万 IU/ kg,最大 30 0万 IU) 92例 ,在 30 m in内静脉给药。结果 :冠脉再通率为 :A组 37.5 % (12 / 32 ) ,B组 5 5 .3%(2 1/ 38) ,C组 81.5 % (75 / 92 ) ;住院病死率 :A组 12 .5 % (4 / 32 ) ,B组 10 .5 (4 / 38) ,C组 5 .4% (5 / 92 ) ;说明 C组疗效明显高于 A、 B两组 (P <0 .0 5 ) ,住院病死率 A组与 B组相似 ,C组低于 A和 B组 ,但差异无显著性 (P >0 .0 5 )。出血并发症发生率 :A组 9.4% (3/ 32 ) ,B组 10 .5 % (4 / 38) ,C组 12 .0 % (11/ 92 ) ;三组间对比无差异 (P >0 .1) ,且三组均无危及生命部位的脑出血。结论 :个体化大剂量尿激酶对 AMI病人进行静脉溶栓治疗能进一步提高疗效而出血并发症无明显增加 ,也是安全的。
Objective: A clinical study on thrombolysis with intravenous urokinase in 162 cases of acute myocardial infarction (AMI) was reported, in order to investigate the effects and bleeding side effects of different doses of urokinase and the safty of the high doses personally. Methods: 162 cases of AMI treated by urokinase within 12 hours or 24 hours individually after onset were divided randomly into three groups, 32 cases in low dose group \[group A, uk500000IU\], 38 cases in middle dose group \[group B, uk 1500000IU\] and 92cases in high dose personally group \[group C, uk>30000IU/kg,total dose no more than 3000000IU\]. Results: The patency rates of group A、B、C was 37.5%(12/32), 55.3%(21/38) and 81.5%(75/92) respectively. In-patient mortality was 12.5%(4/32),10.5%(4/38) and 5.4%(5/92) respectively. Group C was more effective than group A and B(P<0.05);the mortality rate of group A was similar to that of group B, but more than that of group C, and had no statistical significance(P>0.05).Adverse bleeding actions rate were 9.4%(3/32), 10.5%(4/38) and 12.0%(11/92) respectively, and had no statistical significance among the three groups (P>0.1). There were no crisis bleeding in the brain among the three group. Conclusion: The thrombolysis with intravenous urokinase in high dose personally in AMI cases could be more effective and safer. \ \
出处
《广西医学》
CAS
2000年第6期1196-1198,共3页
Guangxi Medical Journal
