摘要
目的对ST段抬高的急性心肌梗死(STEAMI)患者采用新型溶栓剂瑞替普酶(r-PA)静脉溶栓,并且与尿激酶溶栓、直接经皮冠脉介入治疗(PCI)相比较,评价r-PA治疗急性心肌梗死的临床疗效。方法共收集确诊发病6小时以内的STEA-MI患者137例,分为三组,分别给予r-PA10U+5U两次间隔30分钟方案进行溶栓治疗,尿激酶150万U 30分钟静脉滴注溶栓以及直接PCI,比较三组血运重建效果及出血并发症的发生率。结果(1)三组患者血运重建率分别为:r-PA组为83%(44/53),尿激酶组为62.5%(25/40),直接PCI组为90.9%(40/44)。r-PA组与直接PCI组之间无显著性差异(P>0.1),而和尿激酶组之间有显著性差异(P<0.05)。(2)三组患者出现脑出血、消化道出血并发症的发生率分别为:r-PA组为13.2%(7/53),尿激酶组为30.0%(12/40),直接PCI组为9.1%(4/44)。r-PA组与直接PCI组之间无显著性差异(P>0.1),而与尿激酶组之间有显著性差异(P<0.05)。结论注射用r-PA采用10U+5U两次间隔30分钟方案对发病6小时以内STEAMI患者进行溶栓治疗效果好,出血并发症少,是一种安全、方便的溶栓剂。
To evaluate the clinical effects of a new thrombolysisin reteplase（r-PA） for acute myocardial infarction by using it to treat the patients with ST evaluated acute myocardi injection on al infarction （STEAMI） and comparing with urokinase and primary percutaneous coronary intervention（PCI）.Method A total of 137 patients with STEAMI occurred within 6 hours were divided into three groups.Group A（53 cases） accepted reteplsae for intravenous injection with the project of 10U plus 5U twice with an intermittence of 30 minutes.Group B （40 cases） accepted ＇urokinase 150U intravenous dropping within 30 minutes.Group C （44 cases） accepted primary PCI.Then their revascularization rate and incidence of bleeding complications were The rate of revascularization with reteplase was not significantly different from that with primary PCI but was higher than that with urokinase [ 83 % （44/53）, 62.5 % （65/40） and 90.9% （40/44）, respeetively].There was no significant difference in the incidence of bleeding complications between reteplase and primary PCI（P〉0.1 ）,but there was a significant difference between Group A and Group C （P〈0.05）. Conclusions r-PT is safe and effective on STEAMI within 6 hours with low incidence of bleeding complications.
出处
《现代诊断与治疗》
CAS
2008年第1期18-19,共2页
Modern Diagnosis and Treatment
关键词
溶栓
急性心肌梗死
瑞替普酶
Thrombolysis
Acute myocardial infarction
Reteplase
