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《中国医学前沿杂志（电子版）》2014 年第 6 卷第 5 期66 ● 临床研究 ●低分子肝素钙联用尿激酶治疗急性心肌梗死的临床效果观察张永光（顺德中医院　心血管内科，广东　佛山　528300）通讯作者 ：张永光 E-mail ：951074395@qq.com【摘要】 目的 观察和评价低分子肝素钙联合尿激酶治疗急性 ST 段抬高型心肌梗死的临床疗效和安全性。方法　将 2009 年 7 月至 2012 年 11 月于本院就诊的 52 例急性 ST 段抬高型心肌梗死患者纳入研究，根据治疗方法不同分为观察组（24 例）和对照组（28 例），对照组给予常规治疗，观察组在常规治疗基础上，给予尿激酶联合低分子肝素钙溶栓治疗，比较两组临床疗效、冠状动脉再通率和不良反应发生情况。结果　对照组总有效率为 50.0%，观察组总有效率为 83.3%，观察组明显优于对照组，两组比较差异具有显著性（P ＜ 0.05）；观察组患者冠状动脉再通率为 79.2%，明显高于对照组（35.7%），两组比较差异具有显著性（P ＜ 0.05）；两组患者治疗期间均未出现严重不良反应。结论　低分子肝素钙联合尿激酶治疗急性心肌梗死疗效显著，不良反应相对较少，值得临床推广应用。【关键词】 尿激酶 ；低分子肝素钙 ；急性 ST 段抬高型心肌梗死Observation on the clinical effect of low molecular weight heparin combined with urokinase in the treatment of acute myocardial infarctionZHANG Yong-guang (Department of Cardiovascular Medicine, Shunde Hospital of TCM, Guangdong, Foshan 528300,China)Corresponding author: ZHANG Yong-guang , E-mail: 951074395@qq.com【Abstract】 Objective　To observe and evaluate the cliniccal efficacy and safety of low molecular weight heparin combined with urokinase in the treatment of acute ST segment elevation myocardial infarction. Methods　52 patients with acute ST segment elevation myocardial infarction patients in our hospital from July 2009 to November 2012 were included in the study, according to the different treatment methods, the cases were divided into observation group (24 cases) and control group (28 cases), control group was given conventional treatment, observation group on the basis of conventional therapy, were given urokinase and low molecular weight heparin thrombolytic therapy, compared the clinical efficacy, the recanalization rate and the incidence of adverse reactions in two groups. Results　The total effective rate of the control group was 50.0%, total effective rate in observation group was 83.3%, observation group was better than control group, with statistically significant difference between two groups (P ＜ 0.05); observation group of coronary recanalization rate was 79.2%, significantly higher than that of 35.7% in control group, the difference between the two groups was significant (P ＜ 0.05); serious adverse reactions were not found in the two groups during treatment. Conclusion　The efficacy of low molecular weight heparin calcium combined with urokinase in the treatment of acute myocardial infarction is exact, relatively less adverse reactions, it is worthy of clinical application.【Key words】 Urokinase; Low molecular heparin; Acute ST segmentelevation myocardial infarction近年来，随着人们生活水平的提高，饮食结构和生活习惯发生了巨大变化，这些都导致心血管疾病发生率日益升高。急性心肌梗死是冠心病的严重类型[1]，是心血管内科常见的急危重症，是在冠状动脉病变基础之上的严重心肌缺血，而造成缺血的主要原因是动脉不稳定斑块的破溃[2]。急性 ST 段抬高型心肌梗死是冠状动脉急性闭塞引起的心肌缺血性坏死，病情危重，是心源性死亡的主要原因之