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目的为观察３００万Ｕ尿激酶（ＵＫ，由广州天普洛欣生物制品厂生产）静脉溶栓治疗急性心肌梗塞（ＡＭＩ）的临床疗效和安全性。方法对６１１例ＡＭＩ患者进行ＵＫ静脉溶栓治疗，Ｂｏｌｕｓ法给药。随机分为Ａ组（３００万Ｕ）、Ｂ组（２５０万Ｕ）和Ｃ组（１５～２００万Ｕ）。对比观察三组患者临床疗效、副作用、５周病死率、左室射血分数（ＥＦ）、再通时间、各种严重并发症发生率和心肌断层显像（ＳＰＥＣＴ）及心肌缺血面积（ＩＭＡ）定量分析。结果按临床判定标准，Ａ组和Ｂ组梗塞相关血管（ＩＲＡ）再通率各为８１．８％和７４．１％，均显著高于Ｃ组（６９．０％，Ｐ＜０．０１，０．０５）。三组５周病死率分别为３．０３％、４．１５％和８．５６％，Ａ组显著降低（Ｐ＜０．０５）。Ａ组和Ｂ组比Ｃ组轻度出血和中重度出血发生率略有增高，但差异无显著性（Ｐ＞０．０５），三组均未发生脑出血。Ａ组和Ｂ组ＥＦ≥５０％者所占比率显著增高Ｃ组。Ａ组各种严重并发症发生率均显著降低（Ｐ＜０．０５或０．０１）。Ａ组和Ｂ组再通时间均显著缩短［（９９．６３±９．２４）ｍｉｎ对（１５２．６１±１０．９２）ｍｉｎ，Ｐ＜０．００１；（１１２．２１±７．２２）ｍｉｎ对（１５２．６１±１０
The purpose of this study was to observe the clinical efficacy and safety of intravenous thrombolysis in the treatment of acute myocardial infarction (AMI) with 3 million U urokinase (UK, produced by Guangzhou Tempusi Biological Products Factory). Methods 611 patients with AMI were treated with UK intravenous thrombolysis, Bolus administration. Patients were randomly divided into A group (3 million U), B group (2.5 million U) and C group (15 ~ 2 million U). The clinical efficacy, side effects, 5-week mortality, left ventricular ejection fraction (EF), recanalization time, incidence of various serious complications and myocardial infarction (SPECT) and myocardial ischemic area Quantitative analysis. Results According to clinical criteria, the recanalization rates of infarction related vessels (IRA) in group A and group B were 81.8% and 74.1%, respectively, which were significantly higher than those in group C (69.0%, P <0.01, 0.05). The 5-week mortality rates of the three groups were 3.03%, 4.15% and 8.56%, respectively, and the A group was significantly lower (P <0.05). The incidence of mild hemorrhage and moderate to severe hemorrhage in group A and group B was slightly higher than that in group C, but the difference was not significant (P> 0.05). No hemorrhage occurred in all three groups. Group A and B EF ≥ 50% were significantly higher proportion of C group. The incidence of various serious complications in group A was significantly lower (P <0.05 or 0.01). The recanalization time was significantly shorter in group A and group B (99.63 ± 9.24) min vs (152.61 ± 10.92) min, P <0.001; (112.21 ± 7.22) min Right (152.61 ± 10