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目的本文观察尿激酶静脉溶栓对急性心肌梗死（ＡＭＩ）的临床疗效及早期再灌注对ＱＴ离散度（ＱＴｄ）的影响。方法对１２５例ＡＭＩ患者行尿激酶静脉溶栓治疗，根据临床再通指标判断梗塞相关血管（ＩＲＡ）再通率，分析再通与未通组并发症发生率，４周左室射血分数（ＬＶＥＦ）变化，室壁瘤发生率及４周病死率。同时记录１２导联ＥＣＧ测定溶栓前、后ＱＴｄ值，比较溶栓再通与未通ＱＴｄ变化。结果１２５例ＡＭＩ患者尿激酶溶栓总血管再通率６１６％，其中６ｈ内ＩＲＡ再通率７０７％，６～１２ｈ内ＩＲＡ再通率４４１％。无１例脑出血，皮肤粘膜出血占１３７％。溶栓后２ｈ及４周再通组ＱＴｄ较溶栓前及未通组明显降低。结论尿激酶静脉溶栓治疗ＡＭＩ血管再通率高，成功溶栓可降低ＱＴｄ，减少心律失常发生。
Objective To observe the clinical efficacy of intravenous thrombolytic therapy of urokinase on acute myocardial infarction (AMI) and the effect of early reperfusion on QT dispersion. Methods 125 patients with AMI underwent intravenous thrombolytic therapy of urokinase. According to the index of recanalization, the recanalization rate of infarction-related blood vessel (IRA) was determined. The incidence of recanalization and failure of recanalization group was analyzed. The left ventricular ejection fraction LVEF) changes, the incidence of aneurysm and 4-week mortality. At the same time recorded 12 lead ECG before and after thrombolysis QTd value, compare thrombolytic recanalization and failed QTd changes. Results The total recanalization rate of urokinase thrombolysis in 125 AMI patients was 61.6%. The IRA recanalization rate was 70.7% within 6 hours and 44.1% within 6-12 hours. No one case of cerebral hemorrhage, skin and mucous membrane bleeding accounted for 137%. QTd at 2h and 4 weeks after thrombolysis was significantly lower than before and before thrombolysis. Conclusions Urokinase intravenous thrombolysis has a high rate of recanalization of AMI. Successful thrombolytic therapy can reduce QTd and reduce arrhythmia.