摘要
目的 研究前列地尔脂肪乳剂 (Lipo-PGE1 )与尿激酶 (UK)联合溶栓治疗急性心肌梗死 (AMI)的效果。方法 前瞻性临床对照研究。病例为适合溶栓的首次发病 6h内的AMI心功能Killip1～ 3级者。对照组用UK溶栓 (5 0例 ) ,联合溶栓组在用UK前予Lipo -PGE1 1 0 μg静脉注射 (5 0例 )。统计再通率 ,记录再通时间 ,测定溶栓前后的血小板聚集率 ,两周后室壁运动情况及左室功能。结果 联合溶栓组较对照组再通率略有提高 (6 4 %vs 5 8% ,P >0 0 5 ) ,再通时间明显缩短 [(4 5±2 5 )minvs (6 7± 2 5 )min ,P <0 0 5 ],溶栓后 2h的血小板聚集率明显低于对照组 [(31± 1 8) %vs (4 5± 2 2 ) % ,P <0 0 1 ],2周后的梗死部位收缩期室壁增厚率明显高于对照组 [(34± 5 ) %vs (30± 7) % ,P <0 0 5 ]、左室收缩末期容量明显低于对照组 [(5 5± 8)mLvs (6 1± 7)mL ,P <0 0 5 ]。结论 Lipo -PGE1 与UK联合溶栓加快再通速度、提高再通率 。
Objective To investigate the effect of combined thrombolytic therapy of Lipo-PGE 1 plus urokinase (UK) on clinical coronary patency in patients with acute myocardial infarction. Methods The patients with the first AMI (no more than six hours from the onset) were divided into two groups randomly. The control was treated with traditional thrombolysis (UK alone,50 cases), and the combined group was given intravenous injection of Lipo-PGE 1 before traditional thrombolytic therapy (50 cases). No significant differences in baseline characteristics were observed between 2 groups. To record the time of reperfusion and the rate of clinical coronary artery repatency, and test the blood platelet aggregation before and two/ten hours after thrombolysis. Two weeks later, echocardiogram were carried out to examine the extent of wall thickness in systolic period (△T), left ventricular end systolic volum (LVESV), left ventricular ejection fraction (LVEF). Results ①The time from thrombolysis to reperfusion in combined group was shorter than that in the control [(45±25)min vs (67±25)min,P<0 05].②The rate of blood repatency in 2 hours in combined group was little more than that in the control (64% vs 58%, P>0.05). ③The rate of blood platelet aggregation two hours after thrombolysis in combined group were lower than that in control group significantly[(31±18)% vs (45±22)%,P<0 01].④Compared with control group, △T in combined group was higher and the LVESV was less significantly[(34±5)% vs (30±7)%,P<0 05 and (55±8)mL vs (61±7)mL,P<0 05].Conclusion Combining thrombolytic therapy of Lipo-PGE 1 plus UK associated with improving speed and quality of reperfution.
出处
《中国急救医学》
CAS
CSCD
北大核心
2003年第6期392-393,共2页
Chinese Journal of Critical Care Medicine
关键词
心肌梗死
血栓溶解方法
前列地尔
Myocardial infarction
Thrombolytic therapy
Prostaglandin E 1(PGE 1)
