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目的探讨尿激酶溶栓前使用肝素对急性心肌梗死冠状动脉再通和梗死范围的影响。方法随机将 86例急性心肌梗死患者分为早期肝素组和对照组 ,早期肝素组尿激酶溶栓之前静脉注射肝素 ,对照组常规尿激酶溶栓治疗。比较两组治疗前后的心肌梗死面积。结果早期肝素组和对照组的血管再通率分别为 83.33%和 6 0 .5 2 % ( P<0 .0 5 ) ,两组治疗前预计梗死面积无统计学差异 ( P>0 .0 5 )。对照组治疗前后的梗死面积无显著性差异 ( P>0 .0 5 ) ,早期肝素组治疗前后的梗死面积有显著的统计学差异 ( P<0 .0 1)。最终梗死面积和梗死面积变化百分率在两组之间均有显著性差异 ( P<0 .0 5和 P<0 .0 1)。结论早期应用肝素辅助尿激酶溶栓治疗 ,可提高急性心肌梗死早期冠状动脉再通率 ,减少再闭塞 ,缩小梗死面积
Objective To investigate the effect of heparin before urokinase thrombolysis on recanalization and infarct size of coronary artery in patients with acute myocardial infarction. Methods A total of 86 patients with acute myocardial infarction were randomly divided into early heparin group and control group. Heparin was injected intravenously before urokinase thrombolysis in the early heparin group and conventional urokinase thrombolysis in the control group. The infarct size of the two groups before and after treatment was compared. Results The hepatic recanalization rates in the early heparin group and the control group were 83.33% and 60.22% (P <0.05) respectively. There was no significant difference in infarct size between the two groups before treatment (P> 0.05) ). There was no significant difference in the area of infarction before and after treatment in the control group (P> 0.05). The area of infarction before and after treatment in the early heparin group was significantly different (P <0.01). The final percentages of infarct size and infarct size were significantly different between the two groups (P <0.05 and P <0.01). Conclusion Early application of heparin-assisted urokinase thrombolytic therapy can improve the rate of coronary recanalization in the early stage of acute myocardial infarction, reduce reocclusion and reduce infarct size