CAJ | 학술논문

目的探讨对急性心肌梗死(acute myocardial infarction,AMI)进行早期溶栓治疗的疗效。方法本组142例均符合AMI溶栓的适应证，无禁忌证。患者入选后立即嚼服阿斯匹林300mg，以后每日(100～150)mg；尿激酶(urokinase,UK)22 000 IU/kg半小时内静脉滴入，UK滴完后6～12h皮下注射肝素7 500U，每12h一次，持续3～5d。结果 142例中，再通87例(61.3%)，未通55例(38.7%)。发病至开始溶栓时间≤2h、2～4h、4～6h者再通率分别为74.4%、67.3%和43.6%，4h后的再通率明显低于4h以内的再通率(P＜0.05或P＜0.01)。结论早期溶栓治疗可以缩小梗死范围，保护心脏功能，降低病死率，减少并发症。再通率与发病时间至开始溶栓时间密切相关。
목적탐토대급성심기경사(acute myocardial infarction,AMI)진행조기용전치료적료효。방법본조142례균부합AMI용전적괄응증，무금기증。환자입선후립즉작복아사필림300mg，이후매일(100～150)mg；뇨격매(urokinase,UK)22 000 IU/kg반소시내정맥적입，UK적완후6～12h피하주사간소7 500U，매12h일차，지속3～5d。결과 142례중，재통87례(61.3%)，미통55례(38.7%)。발병지개시용전시간≤2h、2～4h、4～6h자재통솔분별위74.4%、67.3%화43.6%，4h후적재통솔명현저우4h이내적재통솔(P＜0.05혹P＜0.01)。결론조기용전치료가이축소경사범위，보호심장공능，강저병사솔，감소병발증。재통솔여발병시간지개시용전시간밀절상관。
Objective　To investigate the effect of the intravenous thrombolytic therapy on acute myocardial infarction (AMI).Method　142 patients with AMI were appropriate candidates for early intravenous thrombolytic therapy without any contra-indications.All patients took aspirin 300mg(the first dose)by chawing at first and then took 100-150mg per day.Urokinase(UK,22 000IU/kg)was given by intravenous dropping within half an hour.6～12 hours later after UK was given,7 500u heparin was given subcutaneously per 12 hours,which lasted 3 to 5 days.Rcsult　The 87 cases (61.3%)of infarct-related arteries were reopened and 55 cases(38.7%)were still blocked.The reopening rates of infarct-related arteries that were treated by thrombolysis no more than 2 hours,within 2 to 4 hours or within 4 to 6 hours after AMI occurred were respectively 74.4%,67.1%and 43.6%.The reopening rate of infarct-related arteries that were treated by thrombolysis later than 4 hours was significantly lower than within 4 hours.Conclusion　The early intravenous thrombolytic therapy in AMI could decrease the infarct areas,protect the heart function,and reduce the mortality and complications.The rate of reopening was closely relative to the time when the thrombolysis began.