依诺肝素辅助瑞替普酶静脉溶栓治疗急性心肌梗死的临床研究

Clinical study of reteplase and enoxaparin as reperfusion therapy in the patients with acute myocardial infarction

目的:探讨瑞替普酶静脉溶栓辅助应用依诺肝素替代普通肝素抗凝治疗急性心肌梗死(AMI)的安全性与有效性。方法:86例AMI患者在瑞替普酶静脉溶栓时随机分为依诺肝素组(45例)和静脉普通肝素组(41例),2周后行冠状动脉造影及冠脉介入治疗(PCI)。观察临床再通率、血管开通率、急性期并发症、出血及不良反应发生率。结果:依诺肝素组与普通肝素组临床再通率、血管开通率比较差异无统计学意义(P>0.05)。两组急性期并发症发生率比较差异无统计学意义(P>0.05)。依诺肝素组出血并发症低于静脉普通肝素组,两组比较差异有统计学意义(P<0.05)。结论:瑞替普酶并依诺肝素用于AMI再灌注治疗是安全有效的。

Objective：To study the efficacy and safety of using reteplase for intravenous thrombolysis therapy and enoxaparin instead of unfractionated heparin（UFH） for anti-coagulati on therapy in the patients with acute myocardial infarction （AMI）. Methods： 86 AMI patients after thrombolytic therapy with reteplase were randomly divided into two groups：enoxaparin group （n=45） and UFH group （n= 41）. Coronary angiography （CAG） and percutaneous coronary intervention （PCI） were performed after two-week thrombolysis therapy. The clinical repatency,infarction related artery （IRA） repatency,major adverse coronary events （MACE）,hemorrhage and adverse events were ob served. Results ：The clinical repatency and infarction related artery were no significant difference between enoxaparin group and UFH group. There was no significant difference in MACE between two groups. The hemorrhage rate were lower in enoxaparin group than in UFH group（P〈0. 05）. Conclusions：It is safe and efficient to use reteplase and enoxaparin for reperfusion therapy in patients with acute myocardial infarction.