金迪

[摘要] 目的 探讨临床上采用尿激酶静脉溶栓对早期急性心肌梗塞治疗中的临床效果。 方法 选择于2014年1月—2014年9月在该院接受治疗的患有早期急性心肌梗塞的患者104例，实验组患者52例，在心电监测下对患者采用尿激酶进行静脉溶栓治疗。对其余52例患者不采用溶栓治疗作为对照组。分别记录下两组患者的成功再通、死亡例数，对两组的再通率和病死率进行比较，并对再通率与溶栓时间之间的关系进行探究。结果 在对患者再通率的比较中，尿激酶静脉溶栓治疗的实验组患者为69.2%，较未采用溶栓治疗的对照组患者3.8%的再通率相比有明显的优势；在病死率的比较中，前者为9.6%明显低于后者15.6%的病死率。6 h内接受治疗患者的再通率为72.2%，而6h后再通率则降低至43.8%。结论 对早期的急性心肌梗塞患者采用尿激酶静脉溶栓方法进行治疗较采用常规方式能够取得更高的再通率，可在一定程度上减少患者的病死率。

[关键词] 静脉溶栓；急性心肌梗塞；再通率；病死率

[中图分类号] R542.22 [文献标识码] A [文章编号] 1674-0742（2015）02（b）-0020-02

Clinical Application of Intravenous Thrombolysis to the Treatment of Early Acute Myocardial Infarction

JIN Di

Shenyang Emergency Center， Shenyang， Liaoning Province， 110000 China

[Abstract] Objective To investigate the clinical effect of intravenous thrombolysis with urokinase on early acute myocardial infarction. Methods 104 cases with early acute myocardial infarction treated in our hospital from January 2014 to September 2014 were selected. 52 cases in the experimental group were given intravenous thrombolysis with urokinase under ECG monitoring. And the other 52 cases in the control group were not given intravenous thrombolysis treatment. The successful number of reperfusion and that of death of the two groups were recorded. The reperfusion rate and mortality rate of the two groups were compared. And the relationship between reperfusion rate and thrombolysis time was investigated. Results The reperfusion rate of the experimental group treated by urokinase was 69.2%， much higher than 3.8% of the group without thrombolytic therapy. The mortality rate of the experimental group was 9.6%， obviously lower than 15.6% of the latter group. The reperfusion rate of the patients received thrombolytic therapy within 6h was 72.2%， while those received the therapy after 6h decreased to 43.8%. Conclusion Patients with early acute myocardial infarction treated by thrombolytic therapy with urokinase have higher reperfusion rate and lower mortality rate to a certain extent as compared with the conventional method.

[Key words] Intravenous thrombolysis； Acute myocardial infarction； Reperfusion rate； Mortality rate

急性心肌梗塞的患者多由于冠状动脉粥样硬化狭窄再结合其他诱导因素，致使粥样斑块破裂，血小板逐渐在斑块表面聚集形成血栓，致使持续性缺血缺氧所引起的心肌坏死。随着现代生活节奏的加快，工作量的增多使越来越多的人负有过重的劳动量，情绪也逐渐趋向不稳定，正常的饮食作息规律被打乱，及生活中吸烟等不良生活习惯，增大了心肌梗塞发生的可能性[1]。……