德国链激酶、国产重组链激酶静脉溶栓治疗急性心肌梗塞49例疗效比较

COMPARISON OF THROMBOLYSIS EFFICACY BETWEEN GERMAN STREPTASE AND HOMEMADE HEBERKINASE IN 49 CASES OF ACUTE MYOCARDIAL INFARCTION

目的：观察德国链激酶（ＳＫ）与国产重组链激酶（ｒＳＫ）在急性心肌梗塞（ＡＭＩ）静脉溶栓治疗中的临床疗效和安全性。方法：将我院ＣＣＵ病房１９９６年３月～１９９７年１２月静脉溶栓治疗ＡＭＩ４９例，分为ＳＫ组２５例和ｒＳＫ组２４例。２组分别用ＳＫ及ｒＳＫ１５０万单位６０ｍｉｎ静脉滴入，伴随用药２组相同。结果：血管再通率ＳＫ组６８％，ｒＳＫ组６６６７％（Ｐ＞００５）。溶栓距发病≤６ｈ；前壁梗塞的患者病死率分别为ＳＫ组１４２９％，ｒＳＫ组１３３３％（Ｐ＞００５）。梗塞血管再通组病死率为３０３％，明显低于未通组的２５％（Ｐ＜００１）。轻度出血并发症：ＳＫ组１２０％，ｒＳＫ组１２５％，无颅内出血。一过性低血压发生率ＳＫ组１２０％，ｒＳＫ组８３％（Ｐ＞００５）。结论：ＳＫ和ｒＳＫ用于静脉溶栓治疗ＡＭＩ疗效肯定，副作用小。ｒＳＫ价格较低，更适于国内推广使用。

Objective:To determine the thrombolytic efficacy and safety of German streptase(SK) and homemade heberkinase(rSK) in treating acute myocardial infarction(AMI).Methods:Fortynine cases of AMI treated in CCU from March 1996 to December 1997 were divided into two groups:group SK,25 patients;and group rSK,24 patients.Intravenous SK and rSK were given within 60 minutes in group SK and group rSK respectively,other therapy was the same in these two groups.Results:Thrombolytic therapy successfully restores antegrade coronary flow in 68% patients in Group SK and in 6667% in Group rSK(P>005).The time to attack were or less than 6 hours.The mortality of 1429% in Group SK and 1333% in Group rSK.Moreover,there is a significant difference between the patients with successful reperfusion(303%)and those with a failure of reperfusion(25%,P<001).Mild bleeding occurred in 120% patients in group SK and 125% in group rSK without any severe bleeding complication.A transient hypotension was observed in 120% patients in group SK,and 83% in group rSK(P>005).Conclusion:SK and rSK are both effective for thrombolysis in AMI treatment with less sideeffects.For its efficacy with a low cost,rSK is expected to be widely used in China in the near future.