小剂量rt-PA不同给药方法治疗急性心肌梗死对心电图ST段变化的影响

Different Ways of Low Dose rt-PA on ST Segment of Electrocardiography for Acute Myocardial Infarction

目的探讨小剂量(50 mg)重组组织型纤溶酶原激活剂(recombinant tissue-type plasminogen activa-tor,rt-PA)30 min、60 min 与90 min 等3种给药方法治疗急性心肌梗死(AMI)对心电图 ST 段变化的影响。方法244例 AMI 患者随机分为 rt-PA 50mg、30min 方案组49例(A 组),60min 方案组76例(B 组)与90min 方案组119例(C 组)。比较3组患者在不同时间的 ST 段回降率。结果溶栓60 min 时,A 组 ST 段回降率均高于 B 组(P<0.05)和 C 组(P<0.01);90 min 时,B 组 ST 段回降率均高于 A 组和 C 组(P<0.05);120 min 时,C 组 ST 段回降率均高于 A 组和 B 组(P<0.05)。结论小剂量 rt-PA 30 min、60 min 给药法可使心电图抬高的 ST 段早期回落,促进心肌早期再灌注。

Objective To evaluate the effects of radid administration of low dose rt-PA 50 mg for 30 min,60 min and 90 minutes on change of ST segment of electrocardiography in acute myocardial infarction（AMI）. Methods 244 AMI patients with ST segment elevation were randomly divided into three groups. The group A （30 min）, the group B （60 min）, the group C （90 min）. The incidence rate of ST segment resolution was observed. Results At 60 min after thrombolysis, the incidence rate of ST segment resolution in group A was higher than that in group B（ P 〈0. 05）and C（ P 〈0. 01 ）. At 90 min,the incidence rate of ST segment resolution in group B was higher than that in group A and C （ P 〈 0. 05） ;At 120min,the incidence rate of ST segment resolution in group C was higher than that in group A and B（ P 〈0. 05）. Conclusion Administration low dose of rt-PA within 30 min and 60 min could make elevated ST segment early resolution, and accelerate myocardial recanalization.