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目的探讨纳络酮与尿激酶联合治疗急性心肌梗死(AMI)的临床疗效。方法将112例 ST 段抬高的 AMI 患者随机分成络酮组(58例)和对照组(54例)。对照组应用尿激酶(UK)150万 u 溶于生理盐水100 ml 中静滴,30 min 滴完。纳络酮组在溶栓前给以纳络酮2 mg 静脉推注,然后以0.01 mg/(kg·min)速度持续静脉泵注,溶栓方法同对照组。各组在溶栓前常规记录18导联心电图,查血常规、血小板、出凝血时间、心肌酶,观察胸痛缓解时间,血清 CPK 峰值提前时间,比较两组再通情况和不良反应出现情况。结果纳络酮组再通成功率明显高于对照组(P<0.001),纳络酮组副作用发生率明显低于对照组(P<0.05)。对照组死亡3例,纳络酮组无死亡者。结论纳络酮可提高 ST 段抬高的 AMI 患者溶栓再通成功率,减少溶栓后并发症的发生。纳络酮在 ST 段抬高的 AMI 患者的溶栓治疗中起着比较重要的作用。
Objective To investigate the clinical efficacy of naloxone combined with urokinase in the treatment of acute myocardial infarction (AMI). Methods One hundred and twelve patients with ST-elevation AMI were randomly divided into ketoconjugate group (58 cases) and control group (54 cases). Control group, urokinase (UK) 1.5 million u dissolved in 100 ml of saline intravenously, 30 min drip finished. Naloxone group was given intravenous injection of naloxone 2 mg before thrombolysis and then continuous intravenous injection at a rate of 0.01 mg / (kg · min). The thrombolysis method was the same as that of the control group. Before the thrombolysis routine recording 18 lead electrocardiogram, check blood, platelets, clotting time, myocardial enzymes, chest pain relief time, serum CPK peak early time, recanalization and adverse reactions were compared between the two groups. Results The success rate of recanalization in naloxone group was significantly higher than that in control group (P <0.001). The incidence of side effects in naloxone group was significantly lower than that in control group (P <0.05). The control group died in 3 cases, naloxone group without death. Conclusion Naloxone improves the success rate of thrombolytic recanalization in patients with ST-elevation AMI and reduces the incidence of post-thrombolysis complications. Naloxone plays a more important role in the thrombolytic therapy of patients with ST-elevation AMI.