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1、不同剂量尿激酶治疗急性心肌梗死临床观察【关键词】心肌梗死；尿激酶；溶栓治疗；副作用［摘要］目的了解不同剂量尿激酶(UK)静脉滴注对急性心肌梗死(AMI)患者的疗效和岀血并发症发生情况。方法61例AMI患者符合WHO的AMI诊断标准，无溶栓禁忌证，随机分成小剂量溶栓组和大剂量溶栓组。小剂量溶栓组31例，以60万uUK溶于5%葡萄糖液100ml溶液中30min内静滴完；大剂量溶栓组30例，以150万uUK溶于5%葡萄糖100ml溶液屮30min内静滴完；其他基础治疗两组相同。每组患者溶栓开始3h内每30min检查一次心电图，以后定期检查;溶栓开始至起病24h内每2h—次血清CK、CK-
2、MB,起病48h测定最后一次。观察心率、心律、血压、胸痛变化和呕叶物、痰液、大小便、皮肤、黏膜的出血征象。结果小剂量溶栓组出血并发症为3.23%,低于大剂量溶栓组的20%,经比较分析差异有显著性(P<0.05),其中两组消化道出血、血痰、血尿发生率之和的比较PV0.05。两组血管再通率、再梗死率、严重并发症发生率、病死率相近，差异均无显著性(P>0.05)。结论以60万u尿激酶静滴法治疗AMT出血并发症尤其脏器出血的发生率明显降低，疗效可靠，更加安全。［关键词］心肌梗死；尿激酶；溶栓治疗；副作用Clinicaltrialofdifferentdosesofurokinaseinpa
3、tientswithacutemyocardialinfarction[Abstract]ObjectiveToinvestigatetheeffectsandadversebleedingactionsofdifferentdoseswithintravenousurokinaseinacutemyocardialinfarction・Methods61casesofacutemyocardialinfarctionweredividedrandomlyintotwogroups,31casesintwodosegroupwithintravenousurokinase60X10
4、4uin5%glucose100mlin30minutesand30casesinhighclosegroupwithintravenousurokinase150X104uin5%glucose100mlin30minutes・Othertreatmentinpatientsofthetwogroupswerecorrespondence・Recordedtheelectrocardiogramofal1patientsper30minuteaftertreatmentinthreehours,thenwasrecordeditattime・Beganwiththrombolyt
5、ictherapyaftertheonsetofacutemyocardialinfarctionfor24hours,testedforserumCKandCK—MBper2hour,the1asttestofserumCKandCK—MBwasdidafterillnessfor48hours・Measuredtheheartrate,therhythmoftheheartbeating,thebloodpressureandaskedforthepaininthechest,andsurveyedadversebleedingactionsofthevornitus,thep
6、hlegm,thestool,theurine,theskin,themucousmembraneofthepatients・ResultsAdversebleedingactionrateswere3.23%inlowdosegroupand20.00%inhighdosegroup,ithadstatisticalsignificancebetweenthetwogroups(P&It;0・05).Andthetotalbleedingactionratesofthedigestivesystem,thephlegmandtheurinehadstatisticalsignif
7、icancebetweenthetwogroups(P&It;0.05).Thepatencyofinfarctrelatedcoronaryarteryrateasassessedbyuniformclinicalcriteriaoccurredwas54.84%and53.33%respectively(P>0.05).Thereinfarctratewas12.91%and10.00%respectively(P>0.05)・Fiveweekmortalityw
