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目的观察尿激酶联用低分子肝素治疗急性心肌梗死的临床效果,为急性心肌梗死的治疗提供参考。方法选择新疆喀什疏附县人民医院2009年6月至2010年12月收治的符合溶栓条件的急性心肌梗死患者64例,随机分为对照组和观察组各32例,对照组患者给予硝酸甘油舌下含服,肠溶阿司匹林口服,镁极化液静脉滴注等治疗。观察组患者在对照组治疗基础上早期给予尿激酶静脉滴注进行溶栓治疗,12h后给予低分子肝素皮下注射。比较两组患者治疗后冠状动脉再通率、心脏事件发生率、病死率和不良反应的差异。结果与对照组比较,观察组患者的冠状动脉再通率明显提高,心脏事件发生率、病死率明显降低,差异有统计学意义(P<0.05)。观察组患者出现皮下出血、镜下血尿、牙龈出血等不良反应,无脑及其他重要脏器出血。结论尿激酶联合低分子肝素可以显著降低急性心肌梗死患者的心脏事件发生率和病死率,且无致命性出血等不良反应发生,疗效可靠、安全性高,值得临床推广。
Objective To observe the clinical effect of urokinase combined with low molecular weight heparin in the treatment of acute myocardial infarction and provide reference for the treatment of acute myocardial infarction. Methods Sixty-four patients with acute myocardial infarction who were eligible for thrombolytic therapy admitted to Kashin County People’s Hospital of Kashgar from June 2009 to December 2010 were randomly divided into control group and observation group of 32 patients. Patients in the control group were given nitroglycerin Sublingual, aspirin, oral, magnesium and other intravenous drip treatment. Patients in the observation group were given intravenous infusion of urokinase for thrombolysis on the basis of the control group. Subcutaneous injection of low molecular weight heparin was given 12h later. The differences of coronary recanalization rate, incidence of cardiac events, mortality and adverse reactions between the two groups were compared. Results Compared with the control group, the recanalization rate of coronary artery was significantly increased in the observation group and the incidence of cardiac events and mortality were significantly decreased (P <0.05). Observation group patients with subcutaneous hemorrhage, microscopic hematuria, bleeding gums and other adverse reactions, no brain and other important organs bleeding. Conclusions Urokinase combined with low molecular weight heparin can significantly reduce the incidence of cardiac events and mortality in patients with acute myocardial infarction, and no fatal hemorrhage and other adverse reactions, reliable, safe and worthy of clinical promotion.