目的 :探讨大剂量尿激酶静脉溶栓治疗心肌梗死的疗效。方法 :用尿激酶治疗急性心肌梗死 6 8例。其中男 42例 ,女2 6例 ;年龄 36～ 6 9岁 ,平均 ( 5 3 .6± 8.2 )岁。溶栓时间放宽至 2 4h内。结果 :溶栓治疗冠脉再通率为 6 4.7% ( 44 / 6 8) ,其中 3h内溶栓冠脉再通率为 85 .7% ( 2 4/ 2 8) ,至 4h为 71.4% ( 10 / 14) ,至 6h为 40 .0 % ( 4/ 10 ) ,至 2 4h为 37.5 ( 6 / 16 ) ;再梗死15 .9% ( 7/ 44 ) ;出血并发症为 17.6 % ( 12 / 6 8) ,其中应用肝素组较高 2 6 .5 % ( 9/ 34) ,有 1例发生脑出血而死亡 ;非肝素组出血并发症发生率为 8.8% ( 3/ 34)。急性期住院病死率为 5 .9% ( 4/ 6 8)。结论 :早期大剂量短时程尿激酶静脉给药治疗急性心肌梗死 ,可提高相关血管再通率。合用肝素不会降低急性期病死率及再梗死率 ,有可能增加出血并发症甚至脑出血的机会 Objective: To investigate the efficacy of intravenous thrombolysis with high-dose urokinase in the treatment of myocardial infarction. Methods: 68 cases of acute myocardial infarction were treated with urokinase. There were 42 males and 26 females, aged from 36 to 69 years, with an average of (53.6 ± 8.2) years. Thrombolysis time to relax within 24 hours. Results: The rate of coronary recanalization was 67.4% (44/68) in thrombolytic therapy. The rate of thrombolysis coronary artery recanalization within 3 hours was 85.7% (2 4/2 8), and to 4 h 71.4% (4/10) to 6h, 37.5 (6/16) up to 24 hours, 15.9% (7/44) to infarct, and 17.6% (12.6% One of them died of intracerebral hemorrhage, and the rate of hemorrhage complication in non-heparin group was 8.8% (3/34). In-hospital mortality was 5.9% (4/68) in the acute phase. Conclusion: The early high-dose short-term urokinase intravenous administration of acute myocardial infarction, can improve the rate of vascular recanalization. Combination of heparin will not reduce the acute mortality and reinfarction rates, may increase bleeding complications or even cerebral hemorrhage opportunities