【摘要】 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。更多还原

【Abstract】 Objective To compare the impact of different doses of urokinase on vascular recanalization and cardiac function of patients with acute myocardial infarction(AMI). Methods A total of 150 patients with AMI were selected in Taihe Hospital of Shiyan from March 2015 to October 2016,and they were divided into A group,B group and C group according to random number table,each of 50 cases. Patients of A group received intravenous drip of low-dose urokinase(0. 5 million U),patients of B group received intravenous drip of middle-dose urokinase(1. 5 million U),while patients of C group received intravenous drip of high-dose urokinase(3 million U). TIMI grading and vascular recanalization rate, index of cardiac function before and after treatment,and incidence of adverse reactions were compared among the three groups. Results TIMI grading of B group and C group was statistically significantly better than that of A group, respectively, meanwhile vascular recanalization rate of B group and C group was statistically significantly higher than that of A group,respectively(P < 0. 05).No statistically significant differences of LVESV,LVEDV or LVEF was found between the two groups before treatment(P >0. 05),while LVESV,LVEDV and LVEF of B and C group were statistically significantly higher than those of A group after treatment(P < 0. 05). Incidence of adverse reactions of C group was statistically significantly higher than that of B group and C group,respectively(P < 0. 05). Conclusion Compared with low-dose urokinase,middle-dose urokinase and high-dose urokinase can more effectively improve the vascular recanalization and cardiac function of patients with AMI,but high-dose urokinase induced risk of adverse reactions is higher,so middle-dose urokinase is effective and safe.更多还原