论文部分内容阅读
目的 :为探讨急性心肌梗死 (AMI)用国产尿激酶 (天普洛欣 )进行静脉溶栓治疗时不同剂量特别是个体化大剂量给药的疗效及出血副作用 ,并探讨大于 3万 IU/ kg(最高 30 0万 IU)使用的安全性。方法 :将入选发病 12 h内个别 2 4h内的 16 2例患者随机分 3组 :A组即低剂量组 (5 0万 IU) 32例 ,B组即中剂量组 (15 0万 IU) 38例 ,C组即个体化大剂量组(>3万 IU/ kg,最大 30 0万 IU) 92例 ,在 30 m in内静脉给药。结果 :冠脉再通率为 :A组 37.5 % (12 / 32 ) ,B组 5 5 .3%(2 1/ 38) ,C组 81.5 % (75 / 92 ) ;住院病死率 :A组 12 .5 % (4 / 32 ) ,B组 10 .5 (4 / 38) ,C组 5 .4% (5 / 92 ) ;说明 C组疗效明显高于 A、 B两组 (P <0 .0 5 ) ,住院病死率 A组与 B组相似 ,C组低于 A和 B组 ,但差异无显著性 (P >0 .0 5 )。出血并发症发生率 :A组 9.4% (3/ 32 ) ,B组 10 .5 % (4 / 38) ,C组 12 .0 % (11/ 92 ) ;三组间对比无差异 (P >0 .1) ,且三组均无危及生命部位的脑出血。结论 :个体化大剂量尿激酶对 AMI病人进行静脉溶栓治疗能进一步提高疗效而出血并发症无明显增加 ,也是安全的。
Objective: To investigate the curative effect and bleeding side effects of intravenous thrombolysis in patients with acute myocardial infarction (AMI) induced by intravenous thrombolysis with different doses, especially individualized high doses and to explore the side effect of more than 30,000 IU / kg (Up to 30 million IU) security. Methods: A total of 162 patients were randomly divided into three groups: group A, low dose group (500,000 IU), group B, middle dose group (150,000 IU) 38 In group C, 92 patients in the high-dose, individualized group (> 30,000 IU / kg, up to 30,000 IU) were intravenously administered within 30 minutes. Results: The rate of coronary recanalization was 37.5% (12/32) in group A, 51.3% (81/38) in group B, and 81.5% (75/92) in group C (4/32) in group B, 10.5% (4/38) in group B, and 5.4% (5/92) in group C, indicating that the efficacy of group C was significantly higher than that of group A and B (P <0. 0 5). The in-hospital mortality rate of group A was similar to that of group B, while that of group C was lower than that of group A and B, but the difference was not significant (P> 0.05). The incidence of bleeding complication was 9.4% (3/32) in group A, 10.5% (4/38) in group B, and 12.0% (11/92) in group C. There was no significant difference between the three groups (P> 0) .1), and all three groups had no intracerebral hemorrhage that was endangering life. Conclusion: Individualization of high-dose urokinase in patients with AMI intravenous thrombolytic therapy can further improve the efficacy of bleeding without significant increase in complications, but also safe.