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本文对25例用尿激酶、15例用去纤酶溶栓治疗的急性心肌梗塞患者体内的组织型纤溶酶原激活剂(tissue Plasminogen Activator,t-PA)的含量、活性及纤溶酶原激活剂抑制物(Plasminogen Activator Inhibitor,PAI)的活性在治疗前后的改变进行了动态观察。结果表明:(1)尿激酶可以显著地提高t-PA的活性,降低PAI的活性,这种作用在用药后0.5h最明显,维持4h左右,去纤酶则无此作用。(2)尿激酶组的再通率(76％)显著高于去纤酶组的再通率(20％),住院病死率12％,低于去纤酶组20％。两组的出血并发症相等,均为20％。提示:尿激酶可以有效地提高急性心肌梗塞患者的纤溶活性,去纤酶用于溶栓治疗可能无效。
In this paper, 25 patients with urokinase, 15 cases of defibrinated thrombolysis in patients with acute myocardial infarction in vivo tissue-type plasminogen activator (tissue Plasminogen Activator, t-PA) content, activity and plasminogen The activity of Plasminogen Activator Inhibitor (PAI) was dynamically observed before and after treatment. The results showed that: (1) Urokinase could significantly increase the activity of t-PA and reduce the activity of PAI. This effect was the most obvious at 0.5h after treatment, maintaining about 4h, defibrase had no such effect. (2) The recanalization rate (76%) of urokinase group was significantly higher than that of defibrase group (20%), the in-hospital mortality rate was 12%, which was lower than that of defibrase group (20%). Bleeding complications in both groups were equal, both 20%. Tip: Urokinase can effectively improve fibrinolytic activity in patients with acute myocardial infarction, defibrase for thrombolytic therapy may be ineffective.