Ishikawa K, Kanamasa K, Ohno M, Morishita M, Ogawa I, Shimizu M, Hayashi T, Sakaguchi Y, Yamashita K, Kamata N
First Department of Internal Medicine, Kinki University School of Medicine, Osakasayama.
J Cardiol. 1989 Mar;19(1):97-101.
Among 263 patients with acute myocardial infarction, 141 were treated with urokinase (UK group) and 122 received no urokinase (conventional group). Urokinase (UK) was administered intracoronarily in 55 cases; intravenously (mainly 1,920,000 units) in 64 cases; and intravenously and intracoronarily in 22 cases. The mortality rates were ascertained three months after admission and during the mean follow-up periods of 17.5 months for the UK group and 24.5 months for the conventional group. The three month mortality was significantly lower in the UK group (10.6%, 15 cases) than in the conventional group (23.8%, 29 cases) (p less than 0.01). The mortality during the entire follow-up period was also lower in the UK group (14.2%, 20 cases) than in the conventional group (26.2%, 32 cases) (p less than 0.05). Fatalities due to cardiac rupture, ventricular fibrillation, cardiac failure, cardiogenic shock and recurrent infarction were uniformly less in the UK group. It was concluded that coronary thrombolysis is an effective means of reducing mortality in acute myocardial infarction.
在263例急性心肌梗死患者中，141例接受了尿激酶治疗（尿激酶组），122例未接受尿激酶治疗（常规组）。55例患者冠状动脉内给予尿激酶；64例静脉给予（主要为192万单位）；22例静脉及冠状动脉内联合给予。在入院后三个月以及尿激酶组平均随访17.5个月、常规组平均随访24.5个月期间确定死亡率。尿激酶组三个月死亡率（10.6%，15例）显著低于常规组（23.8%，29例）（p<0.01）。整个随访期间尿激酶组死亡率（14.2%，20例）也低于常规组（26.2%，32例）（p<0.05）。尿激酶组因心脏破裂、心室颤动、心力衰竭、心源性休克和再发梗死导致的死亡均较少。得出的结论是，冠状动脉溶栓是降低急性心肌梗死死亡率的有效手段。
