目的:观察对急性心肌梗死(AMI)病人院前及院内尿激酶静脉溶栓的有效性及安全性。方法:人选AMI病人120例,按发病时间至开始静脉溶栓给药的时间,两组均为≤12小时。入选者立即嚼服阿司匹林300mg,给予尿激酶100万U入20ml生理盐水10分钟内静注,再用150万U入100ml生理盐水中60分钟内滴注。结果:院前溶栓比院内溶栓时间平均提前1.4小时。临床开通率,院前组76％,院内组63％。随访5周观察:反复心绞痛发作、重度心律失常和心源性死亡,院前组明显优于院内组;心功能不全、心肌再梗死、多巴酚丁胺心脏负荷试验存活心肌和室壁瘤发生的比率、出血并发症两组无明显差异。结论:为了提高梗塞相关血管的开通率和降低急性期病死率,除提早溶栓时间外,早期识别高危病人及时有效的稳定血液动力学是非常重要的。 Objective: To observe the efficacy and safety of intravenous thrombolytic therapy of urokinase in patients with acute myocardial infarction (AMI). Methods: One hundred and twenty patients with AMI were selected, and the time from the onset to the start of intravenous thrombolysis was used. Both groups were ≤12 hours. The participants immediately chew aspirin 300mg, give urokinase 1000000 U into 20ml saline intravenously within 10 minutes, and then 1.5 million U into 100ml saline instillation within 60 minutes. Results: Prehospital thrombolytic therapy was 1.4 hours earlier than that in hospital. Clinical opening rate, pre-hospital group 76%, hospital group 63%. Follow up of 5 weeks observation: recurrent angina pectoris, severe arrhythmia and cardiac death, pre-hospital group was significantly better than the hospital group; cardiac insufficiency, myocardial infarction, dobutamine stress test cardiomyocytes and aneurysm occurred Rate, bleeding complications no significant difference between the two groups. CONCLUSIONS: In order to improve infarct-related vascular turnover and reduce acute-phase mortality, in addition to early thrombolysis time, early identification of high-risk patients with timely and effective stable hemodynamics is very important.