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目的比较不同剂量尿激酶对急性心肌梗死(AMI)患者血管再通及心功能的影响。方法选取2015年3月—2016年10月十堰市太和医院收治的AMI患者150例,采用随机数字表法分为低剂量组、中剂量组及高剂量组,每组50例。低剂量组、中剂量组及高剂量组患者分别给予尿激酶50万U、150万U及300万U静脉滴注。比较3组患者TIMI分级及血管再通率、治疗前后心功能指标、不良反应发生率。结果高剂量组、中剂量组患者TIMI分级优于低剂量组,血管再通率高于低剂量组(P<0.05)。3组患者治疗前左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF)比较,差异无统计学意义(P>0.05);高剂量组、中剂量组患者治疗后LVESV、LVEDV、LVEF高于低剂量组(P<0.05)。高剂量组患者不良反应发生率高于中剂量组、低剂量组(P<0.05)。结论与低剂量尿激酶(50万U)相比,高剂量(300万U)、中剂量(150万U)尿激酶可更有效地促进AMI患者血管再通并改善患者心功能,但高剂量尿激酶所致不良反应率较高,150万U是尿激酶治疗AMI的安全、有效剂量。
Objective To compare the effects of different doses of urokinase on revascularization and cardiac function in patients with acute myocardial infarction (AMI). Methods 150 patients with AMI admitted to Taihe Hospital of Shiyan from March 2015 to October 2016 were randomly divided into low dose group, middle dose group and high dose group with 50 cases in each group. Low-dose group, middle-dose group and high-dose group were given urokinase 500000 U, 1.5 million U and 3 million U intravenous infusion. TIMI classification and recanalization rate were compared between the three groups. The cardiac function indexes and the incidence of adverse reactions before and after treatment were compared. Results The TIMI grade of high-dose group and medium-dose group was better than that of low-dose group, and the rate of recanalization was higher than that of low-dose group (P <0.05). There was no significant difference in LVESV, LVEDV and LVEF between the three groups before treatment (P> 0.05). The high dose group, medium dose After treatment, LVESV, LVEDV and LVEF were higher than those in low-dose group (P <0.05). The incidence of adverse reactions in high-dose group was higher than that in middle-dose group and low-dose group (P <0.05). Conclusion Compared with low dose urokinase (500,000 U), high dose (3 million U) and medium dose (1.5 million U) of urokinase can promote recanalization and improve cardiac function more effectively in AMI patients. However, high dose Urokinase caused by a higher adverse reaction rate, 1.5 million U is the safe and effective dose of urokinase in the treatment of AMI.