摘要
目的比较瑞替普酶与尿激酶溶栓治疗急性心肌梗死的疗效,并探讨其对患者纤溶指标的影响。方法回顾性分析2014年1月至2019年8月泾阳县医院心血管内二科收治的220例急性ST段抬高型心肌梗死患者的临床资料,根据治疗方法不同分组,其中98例接受瑞替普酶溶栓治疗者纳入观察组,122例接受尿激酶溶栓治疗者纳入对照组。比较两组患者2 h内冠脉再通情况,治疗前及治疗后4 h血清纤溶酶原(PLG)、组织型纤溶酶原激活物(t-PA)、溶酶原激活物抑制剂(PAI-1)活性,以及住院期间心血管事件、出血事件的发生情况。结果观察组患者溶栓开始后30 min、60 min、120 min冠脉再通率分别为34.69%、59.18%、85.71%,明显高于对照组的14.75%、29.51%、57.38%,差异均有统计学意义(P<0.05);治疗后4 h时,两组患者的血清t-PA活性水平升高,PLG、PAI-1活性水平则降低,且观察组明显优于对照组,差异均有统计学意义(P<0.05);住院期间,观察组与对照组患者心血管事件发生率分别为6.12%和8.20%,差异无统计学意义(P>0.05);住院期间,观察组患者的出血发生率为4.08%,明显低于对照组的13.11%,差异有统计学意义(P<0.05)。结论瑞替普酶溶栓治疗急性心肌梗死比尿激酶具有更强的纤溶活性以及更高的血管开通率,且具有出血并发症发生风险低的优势,安全性较好。
Objective To compare the efficacy of reteplase and urokinase thrombolysis on acute myocardial infarction and influence on fibrinolysis index. Methods From January 2014 to August 2019, the clinical data of 220 patients with acute ST segment elevation myocardial infarction admitted to the Second Department of Cardiology, Jingyang County Hospital were analyzed retrospectively. According to the different treatment methods, the patients were divided into two groups: 98 patients receiving reteplase thrombolytic therapy were included into the observation group,and 122 patients receiving urokinase thrombolytic therapy were included into the control group. The coronary recanalization within 2 hours, the activities of serum plasminogen(PLG), tissue type plasminogen activator(t-PA), and plasminogen activator inhibitor(PAI-1) before and 4 hours after treatment, as well as the occurrence of cardiovascular events and bleeding events during hospitalization were compared between the two groups. Results The recanalization rate of 30 minutes, 60 minutes and 120 minutes after thrombolysis in the observation group was 34.69%, 59.18%, and 85.71%,respectively, which were significantly higher than 14.75%, 29.51%, and 57.38% in the control group(P<0.05). After treatment, the serum t-PA activity level of the two groups increased, while the PLG and PAI-1 activity levels decreased significantly, and the levels in the observation group was significantly better than those in the control group(P<0.05). During hospitalization, the incidence of cardiovascular events was 6.12% in the observation group versus 8.20% in the control group(P>0.05). During hospitalization, the incidence of bleeding events was 4.08%, which was significantly lower than 13.11%of the control group(P<0.05). Conclusion Compared with urokinase, reteplase thrombolysis in acute myocardial infarction results in stronger fibrinolytic activity, higher recanalization rate, and lower risk of bleeding complications.
作者
孙颖莉
陈妮
王改
SUN Ying-li;CHEN Ni;WANG Gai(Second Department of Cardiology,Jingyang County Hospital,Xianyang 713700,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第23期3021-3024,共4页
Hainan Medical Journal
关键词
急性心肌梗死
静脉溶栓
瑞替普酶
尿激酶
心血管事件
安全性
Acute myocardial infarction
Intravenous thrombolysis
Reteplase
Urokinase
Cardiovascular events
Security
