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目的探讨小剂量尿激酶治疗糖尿病合并非ST段抬高的急性冠脉综合征(ACS)的可行性。方法对20例糖尿病合并非ST段抬高的ACS患者,在充分抗凝、抗血小板基础上延迟2h静滴尿激酶50万IU,q12h×2d。结果48h内胸痛完全消失和(或)下降的ST段回升50%以上共15例(占75%);48h后至3个月观察期内心脏事件(包括再发胸痛、AMI、死亡)总次数为15次,涉及病例为4例;8例有视网膜病变患者均无出血并发症。结论在充分抗凝、抗血小板基础上延迟2h应用小剂量尿激酶治疗糖尿病合并非ST抬高的ACS方案疗效显著,且不增加出血风险。
Objective To investigate the feasibility of low-dose urokinase in the treatment of diabetic patients with acute coronary syndrome (ST-elevation). Methods 20 patients with diabetes mellitus and non-ST-segment elevation ACS were treated with 500uI IU and q12h × 2d delayed intravenous urokinase 2h on the basis of adequate anticoagulation and antiplatelet. Results Fifteen patients (75%) were recovered more than 50% of the patients with complete disappearance and / or decline of chest pain within 48 hours. The total number of cardiac events (including recurrent chest pain, AMI, death) during the observation period from 48 hours to 3 months 15 times, involving 4 cases of cases; 8 cases of retinopathy patients without bleeding complications. Conclusions The application of low-dose urokinase for 2 hours on the basis of adequate anticoagulation and antiplatelet therapy in the treatment of diabetic patients with non-ST-elevation ACS is effective and does not increase the risk of bleeding.