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为了确定国产尿激酶的有效剂量,我们对发病≤12h的急性心梗患者进行50万和75万单位静脉溶栓临床对照研究,对照组22例,50万组23例,75万组33例。结果:梗塞有关的冠脉早期再通率对照组为零,尿激酶50万和75万单位组分别为13.04%和42.42%,P<0.05,与对照组比较50万单位组P>0.05,75万单位组P<0.05;出院时梗塞面积对照组扩大,尿激酶50万和75万单位组缩小(P<0.05),与对照组比较50万单位组P>0.05,75万单位组P<0.05;呈现心肌挽救的患者对照组占11.11%,尿激酶50万和75万单位组分别为38.87%和42.84%,与对照组比较P分别>0.05和<0.05,证明国产尿激酶静脉溶栓50万单位剂量不足,75万单位为有效剂量。溶栓后50万和75万单位组静脉给肝索总出血率分别为12.5%和50%,P<0.05,75万单位组皮下给肝素总出血率为16.66%,与75万单位静脉给肝素比较P<0.05,与未用者比较P>0.05,说明国产尿激酶溶栓后出血发生率与尿激酶剂量、应用肝素和肝素给药方法有关,皮下给肝素安全有效、值得推广。
In order to determine the effective dose of domestic urokinase, we conducted a clinical controlled trial of 500000 and 750000 intravenous thrombolysis in patients with acute myocardial infarction ≤12h. There were 22 cases in control group, 23 cases in 500,000 cases and 33 cases in 750,000 cases. Results: The infarct-related coronary recanalization rate was zero in the control group. The number of urokinase in 500,000 and 750,000 units was 13.04% and 42.42%, respectively, P <0.05, compared with the control group, 500,000 units P> 0.05,75 (P <0.05). The area of infarction expanded at discharge, the number of urokinase in 500000 and 750000 units was reduced (P <0.05), compared with the control group, 500000 units of P> 0.0575 million units P <0.05 ; Myocardial rescue patients accounted for 11.11% of the control group, 500000 and 750,000 units of urokinase were 38.87% and 42.84%, respectively, compared with the control group P> 0.05 and <0.05, that the domestic urokinase 500000 intravenous thrombolysis Unit dose is insufficient, 750,000 units for the effective dose. After thrombolysis, the total hemorrhage rate of hepatic cord in the 500,000 and 750,000 unit groups was 12.5% and 50%, respectively. P <0.05 and 7.5 million units subcutaneously gave the total hemorrhage rate of heparin was 16.66% P <0.05, compared with no P> 0.05, indicating that the incidence of bleeding after thrombolysis with urokinase dose, the application of heparin and heparin administration methods, subcutaneous heparin safe and effective, it is worth promoting.