Effective thrombolytic therapy is effective for patients with acute myocardial infarction (AMI) after admission to the hospital. The effective measures to save the patient's life, control the progress of the disease and reduce mortality. In order to analyze the application value of urokinase intravenous thrombolysis in patients with AMI, 72 patients with AMI from August 2012 to August 2013 were randomly selected as the research object, and the effect of urokinase intravenous thrombolysis was observed. The results were as follows.
1 materials and methods
1.1 general information
From August ~2013 August 2012, 72 patients with AMI in our hospital were randomly selected as the study object, and the 72 patients were randomly divided into conventional treatment group and urokinase group. 22 patients were male, 20 female, aged 29~69 (49.42 + 5.23) years old. The age, gender and disease of the two groups were not statistically significant (P>0.05).
1.2 method
Conventional treatment group of 36 cases of patients were treated with conventional therapy and specific methods: first of all the patients implement ECG monitoring and oxygen, and asked the patients bed rest, clinical give patients with low molecular weight heparin calcium combined with enteric coated aspirin treatment. And patients in urokinase group on the basis of conventional therapy using urokinase (Harbin hi tech White Swan Pharmaceutical Group Co., Ltd. Sinopharm quasi word H10930112) intravenous thrombolytic therapy. Before thrombolysis, take 200 mg of oral aspirin (Yunlong Pharmaceutical Co., Ltd. Yunnan Sinopharm quasi word H53020321); then give 50 million U urokinase plus 0.9% sodium chloride injection 40ml intravenous injection; followed by in 100 million U urokinase add 100 ml of 0.9% sodium chloride injection, intravenous drip, drip medicine injection time within 30 minutes. After the beginning of the dissolution of the 12h, the 12h was injected with 5000U low molecular weight heparin calcium. The next day, the 5~7d. was treated with 100mg, and the 1 time was /d.
1.3 observation index
After admission, the myocardial enzyme was immediately after the thrombolysis, and the patients were observed to observe the patient's condition, serum creatine kinase (CK) and creatine kinase isoenzyme MB (CK-MB) level. Two days after the continuous monitoring of the patient, the changes of ECG were observed. The assessment criteria for the re - pass of thrombolysis: (1) the chest pain disappeared within the 2H (2), and the 2D (3) reached a peak in the serum creatine kinase MB (three), which was more than two and more than two (1) and (2).
1.4 statistical methods
Analysis of statistical software SPSS 20.0 for this research obtained data, count data in percentage said by chi square test and measurement data to mean + standard deviation (x Yan + s) expressed by t test, P < 0.05 for differences have statistical significance.
2 Results
2.1 comparison of two groups of patients
The re pass rate of the urokinase group was 66.67%, which was significantly higher than that of the conventional treatment group (P<0.05). After treatment, the serum levels of CK and CK-MB were significantly higher than those in the conventional treatment group (P <0.01), see Table 1
2.2 analysis of the effect of urokinase group on the re - pass rate
In the urokinase group, the time of thrombolysis was different, and the rate of reperfusion was different. The time of thrombolysis was earlier, the rate of the patients was higher, but no significant difference was statistically significant. See Table 2
2.3 the incidence of adverse reactions in the two groups
After treatment, 4 patients had adverse reactions (11.11%), 2 patients were treated for 5 weeks, the mortality rate was 5.56%; 12 patients were treated by conventional treatment group (33.33%), 6 patients were treated for 5 weeks, the mortality rate was 16.67%, the two groups had no significant difference; the adverse reaction of urokinase group was significantly lower than that of conventional treatment group (P<0.05). See Table 3
3 discussion
As soon as possible, the key to the treatment of AMI is to control the development of myocardial infarction and improve the survival rate and quality of life. Thrombolytic therapy is an important method for clinical treatment of AMI patients. Thrombolytic drugs are mainly represented by urokinase. It is a double stranded serine protease extracted from human urine or renal cell tissue culture, which can be directly converted into active type plasminogen activator in the circulating blood of patients. In the study of urokinase group, the rate of reperfusion was 72.22% (26/36), and the re pass rate was 27.78% (10/36), the difference was statistically significant (P<0.05), while the serum CK and CK-MB levels were significantly higher than those in the conventional treatment group (<0.01 P).
AMI's golden rescue time is 3~6h after the patient's coronary artery occlusion, the myocardial tissue of patients with this period of time is a reversible pathological change, in this period of time to implement early thrombolytic therapy can make patients with blood vessels and then, and effectively reduce the incidence of complications, greatly reduce the infarct size, and ease the symptoms of patients. The results of this study can achieve 77.78% of the rate of re - pass rate in 0~2h, and the rate of re - pass rate of 3~6h is 60%, the rate of 7~12h is 50%. The adverse reaction of the urokinase group was significantly lower than that of the conventional treatment group (P<0.05). All in all, the clinical effect of urokinase thrombolytic therapy for AMI patients is remarkable, safe and high, it is worthy of clinical application.
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