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本文作者采用前瞻性、随机双盲、安慰剂对照试验方法,评价了早期静注肝素在纤溶酶原激活物(rt-PA)治疗后对冠脉再通、心梗面积和左心室栓子形成的影响,同时也比较了出血性并发症的发生率。方法:将652例(年龄21～70岁)经临床及心电图证实、症状发作在6小时内的急性心肌梗塞(AMI)患者随机分为溶栓十肝素组和溶栓十安慰剂组。全部患者均给予首剂rt-PA10mg继而第一小时给予50mg,以后每2小时20mg维持,阿斯匹林首剂250mg静注,以后75-125mg隔日口服。不同的是肝素组在注射rt-PA后即刻静注肝素5000单位,并以每小时1000单位的维持量至冠脉造影。
In a prospective, randomized, double-blind, placebo-controlled trial, the authors evaluated the effects of early intravenous heparin on recanalization of coronary arteries, infarct size, and left ventricular embolus after treatment with plasminogen activator (rt-PA) The formation of the impact, but also compared the incidence of hemorrhagic complications. Methods: A total of 652 acute myocardial infarction (AMI) patients aged 21-70 years and confirmed by clinical and electrocardiographic evidence of intractable symptoms within 6 hours were randomly divided into thrombolysis and placebo group. All patients were given the first dose of rt-PA10mg followed by the first hour to give 50mg, after every 20 hours to maintain 20mg, aspirin first dose of 250mg intravenously, after 75-125mg orally the next day. The difference was that in the heparin group, 5000 units of heparin were intravenously injected immediately after injection of rt-PA and maintained at a coronary angiographic level of 1000 units per hour.