[摘要] 目的 觀察小劑量重組織型纖溶酶原激活劑(rt-PA)、尿激酶(UK)和重組鏈激酶(r-SK)治療急性心肌梗死的療效和安全性。方法 114例急性心肌梗死患者隨機分為rt-PA組38例，UK組37例，r-SK組39例。分別應用纖溶酶原激活劑50 mg、尿激酶150萬u、鏈激酶150萬u靜脈輸入。結(jié)果 rt-PA組、UK組、r-SK組臨床血管再通率分別為84.21%、51.35%、69.23%，三者之間療效比較P<0.05。3組溶栓后不良反應、5周病死率比較P>0.05，差異無顯著性。結(jié)論 rt-PA治療急性心肌梗死的療效明顯優(yōu)于UK和r-SK，而r-SK的療效優(yōu)于UK。溶栓后不良反應、5周病死率比較差異無顯著性。
[關(guān)鍵詞] 小劑量重組織型纖溶酶原激活劑；尿激酶；重組鏈激酶；急性心肌梗死
Clinical comparison and analysis of low dose recombinant tissue-type plasminogen activator,urokinase and recombinant streptokinase in embolism therapy for acute myocardial infarction
ZHAO Guozhong,LIN Wei,FENG Xiaolan.Hospital of Scientific City，Mianyang 621900,China
[Abstract] Objective To observe the therapeutic effect and safety of low dose recombinant tissue-type plasminogen activator(rt-PA),urokinase(UK) and recombinant streptokinase(r-SK) in embolism therapy for acute myocardial infarction. Methods One hundred and fourteen cases were randomly divided into rt-PA group(38 cases),urokinase group(37 cases) and recombinant streptokinase group(39 cases),which were treated with 50 mg rt-PA,1.5Mu UK and1.5Mu r-SK intravenous infusion respectively. Results The clinical reperfusion rates in rt-PA,UK and r-SK was 84.21%,51.35% and 69.23%(P<0.05).Among the three groups,there was no significant difference in side effect and 5-week mortality(P>0.05).Conclusion Low dose rt-PA was effective for acute myocardial infarction than UK and r-SK,and the therapeutic effect of r-SK was better than UK.There was no significant difference in side effect and 5-week mortality after thrombolytic therapy.
[Key words] low dose recombinant tissue-type plasminogen activator;urokinase;recombinant streptokinase;acute myocardial infarction
盡早、充分、持久地開通相關(guān)血管是挽救急性心肌梗死(AMI)患者生命和改善預后的關(guān)鍵所在，及早實施靜脈溶栓治療是目前國內(nèi)外推薦的冠狀動脈再通的有效方法之一。盡管我國部分有條件的醫(yī)院能開展急診經(jīng)皮冠狀動脈介入治療(PCI)，但多數(shù)醫(yī)院尚不能常規(guī)開展該項目，且我國目前正在規(guī)范PCI的技術(shù)準入制度，因此，靜脈溶栓治療AMI對于基層醫(yī)院仍然是最重要的血運重建手段。筆者應用小劑量重組織型纖溶酶原激活劑(rt-PA)、尿激酶(UK)與重組鏈激酶(r-SK)治療AMI以期尋找一種更有效和合理的AMI治療方案。
[關(guān)鍵詞] 小劑量重組織型纖溶酶原激活劑；尿激酶；重組鏈激酶；急性心肌梗死
Clinical comparison and analysis of low dose recombinant tissue-type plasminogen activator,urokinase and recombinant streptokinase in embolism therapy for acute myocardial infarction
ZHAO Guozhong,LIN Wei,FENG Xiaolan.Hospital of Scientific City，Mianyang 621900,China
[Abstract] Objective To observe the therapeutic effect and safety of low dose recombinant tissue-type plasminogen activator(rt-PA),urokinase(UK) and recombinant streptokinase(r-SK) in embolism therapy for acute myocardial infarction. Methods One hundred and fourteen cases were randomly divided into rt-PA group(38 cases),urokinase group(37 cases) and recombinant streptokinase group(39 cases),which were treated with 50 mg rt-PA,1.5Mu UK and1.5Mu r-SK intravenous infusion respectively. Results The clinical reperfusion rates in rt-PA,UK and r-SK was 84.21%,51.35% and 69.23%(P<0.05).Among the three groups,there was no significant difference in side effect and 5-week mortality(P>0.05).Conclusion Low dose rt-PA was effective for acute myocardial infarction than UK and r-SK,and the therapeutic effect of r-SK was better than UK.There was no significant difference in side effect and 5-week mortality after thrombolytic therapy.
[Key words] low dose recombinant tissue-type plasminogen activator;urokinase;recombinant streptokinase;acute myocardial infarction
盡早、充分、持久地開通相關(guān)血管是挽救急性心肌梗死(AMI)患者生命和改善預后的關(guān)鍵所在，及早實施靜脈溶栓治療是目前國內(nèi)外推薦的冠狀動脈再通的有效方法之一。盡管我國部分有條件的醫(yī)院能開展急診經(jīng)皮冠狀動脈介入治療(PCI)，但多數(shù)醫(yī)院尚不能常規(guī)開展該項目，且我國目前正在規(guī)范PCI的技術(shù)準入制度，因此，靜脈溶栓治療AMI對于基層醫(yī)院仍然是最重要的血運重建手段。筆者應用小劑量重組織型纖溶酶原激活劑(rt-PA)、尿激酶(UK)與重組鏈激酶(r-SK)治療AMI以期尋找一種更有效和合理的AMI治療方案。