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1、急性心肌梗死静脉溶栓临床研究【摘要】目的观察急性心肌梗死静脉溶栓的临床疗效及血管再通与死亡、溶栓吋间、并发症、心功能之间的关系。方法尿激酶150万U加入5%葡萄糖溶液100ml中于半小时内静脉滴入。结果142例急性心肌梗死静脉溶栓后血管再通80例(56.34%),-血舗S62例(43.66%),死亡9例(6.34%),其中血管再通组和未通组死亡率分别为2.50%和11.29%(PV0.0I)；再通纽心衰、休克、严重心律失常的发生率均明显低于未通组，心输出最及左室射血分数明显高于未通组；溶栓在急性心肌梗死
2、发作6h内开始者英血管再通率明显>6h以上者。结论对有溶栓指征而无禁忌证的急性心肌梗死患者尽早开始溶栓治疗，可以减少并发症，改善心功能，降低死亡率。【关键词】急性心肌梗死；尿激酶；溶栓ClinicalStudyofAcuteMyocardialInfarctionbyDissolvingThrombiwithUrokinaseChenWanqiang,XueChengxiang,SongHaibo,MaHui,TangHong,TangLili(The3rdHospitalofPLA,Baoji7210
3、04,China)Abstract：ObjectiveToobservethecurativeefficacyontreatmentforpatientswithacutemyoccirdialinfarctionbydissoluteionofthrombiwithurokinaseandtofindouttherelationshipbetweenintravenousthrombolyticpatencyandmortality,timeofdissolutionofthrombi,complic
4、ations,cardiacfunctions.MethodsDissolve1500000IUuroknasein100ml5%glucoseinjectionpriortoinfusionandthenadministerwithinhalfahour.Results80cases1thombi(56.34%)weresuccessfullydissolvedand62cases(43.66%)wereunsuccessful;therewere9patientsdead(6.34%)amongto
5、talnumbersduringthetreatment;thedeathrateofthesuccessgroupsandtheunsuccessgroupswasrespectively2.50%and11.29%(P<0.01)・Furthermorethesucceedinggroups*complications(suchastheheartfailing,shockandseriouscardiacarrhythmia)wasmuchlowerthanthoseofunsuccessgrou
6、ps,meanwhilewefoundthatthecardiacoutput(CO)andleftventricularejectionfraction(LVEF)weremuchmorehigherthanthoseofunsuccessgroups;thesuccessrateofdissolutionofthrombiwithinthefirst6hourswasmuchhigherthanthatofupwardsof6hours・ConclusionBasisonourclinicaltre
7、atmentsobservation,wheentreatingAMIpatientsjfhavingdissolvingthrombisymptomsandnoforbidsymptoms^weshouldtrytodissolvethrombiassoonaswecan,becausethroughthismethodwecanreducethecomplicationsandimprovecardiacfunction,themostimportant,themostimportantthingi
8、sthatwedecreasethemortality.Keywords：acutemyocardialinfarction;urokinase;dissolutionthrombi急性心肌梗死(AMI)是心脏内科的急诊，具有发病急、进展快、死亡率高的特点，70年代以前死亡率高达近30%[1],严重危害人们的身休健康，我们从80年代中期开始用静脉溶栓治疗急性心肌梗死，90年代后进一步完善和标准化，使病死率下降到7%以下，急性期病死率降低了8
