目的：分析尿激酶溶栓联合左旋精氨酸在急性ST段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）患者临床治疗中应用的安全性及有效性。方法回顾性分析本院2014年2月至2015年2月收治的100例急性STEMI患者的临床资料，根据治疗方法不同将其分为对照组和观察组，每组各50例。对照组患者采取常规溶栓治疗（氯化钠＋尿激酶），观察组患者在常规溶栓治疗基础上加用左旋精氨酸。对比分析两组患者不良心血管事件发生情况及临床疗效。结果治疗48小时后，观察组患者的死亡率、心肌梗死及心绞痛发生率均显著低于对照组（P＜0.05）。治疗1个月后，观察组患者心肌梗死及心绞痛发生率均显著低于对照组（P＜0.05），无新发死亡病例。治疗结束后，对照组患者治疗总有效率显著低于观察组（P＜0.05）。两组患者中6例溶栓治疗失败后转为急诊经皮冠状动脉介入治疗，效果良好。结论激酶溶栓联合左旋精氨酸治疗急性STEMI能够显著降低患者死亡率和不良心血管事件发生率，提高临床治疗有效率。%Objective To analyze the efficacy and safety of urokinase thrombolysis combined with L-arginine in the treatment of acute ST-segment elevation myocardial infarction (STEMI). Method Retrospective analyzed the clinical data of 100 cases of acute STEMI patients admitted in our hospital from February 2014 to February 2015. According to the different clinical treatments, they were divided into control group and observation group, 50 cases in each group. Control group patients were given conventional thrombolysis therapy (sodium chloride + urokinase);observation group patients were treated with L-arginine in addition to routine thrombolysis treatments. The incidence rate of adverse cardiovascular events and efficacy of the two groups were compared. Result 48 hours after treatment, mortality, incidence of myocardial infarction and angina pectoris of observation group were all significantly lower than control group (P<0.05);1 month after treatment, the incidence rates of myocardial infarction and angina pectoris of observation group were significantly lower than control group (P < 0.05). After accomplishing the treatment, the total effective rate of control group was significantly lower than observation group (P<0.05). A total of 6 cases were performed primary PCI after failed thrombolysis and showed good efficacy. Conclusion Uro kinase thrombolysis combined with L-arginine in the treatment of acute STEMIcan significantly reduce the mortality and incidence rate of adverse cardiovascular evenets, improve the clinical efficacy.
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