栓体舒、尿激酶溶栓治疗急性心肌梗死80例疗效观察

Observation on therapeutic efficacy on actilyse and urokinase thrombolysis on 80 cases with acute myocardial infarction

目的：观察栓体舒（重组组织型纤溶酶原激活因子，ｒｔＰＡ）和尿激酶（ＵＫ）对急性心肌梗死（ＡＭＩ）患者的溶栓疗效。方法：将ＡＭＩ患者８０例随机分为Ａ组（３８例，应用ｒｔＰＡ溶栓）和Ｂ组（４２例，应用ＵＫ溶栓）。结果：２组冠状动脉（冠脉）血管总再通率为６０．０％。Ａ组与Ｂ组冠脉血管再通率分别为７３．６％和４７．６％，２组有显著性差异（Ｐ＜０．０１）。病死率分别为５．３％和１１．９％，２组无显著性差异，Ｐ＞０．０５。继发内脏出血发生率分别为０和１４．３％，Ａ组明显低于Ｂ组（Ｐ＜０．０１）。溶栓再通患者病死率（０）明显低于未溶通者（２１．９％），Ｐ＜０．０１。溶栓开始的时间越早越好，发病６小时以内溶栓的患者血管再通率为７８．３％，明显高于６小时～２４小时溶栓者（３５．３％），Ｐ＜０．０１。结论：ｒｔＰＡ用于ＡＭＩ紧急溶栓的临床疗效明显优于ＵＫ，且副作用少。

Objective:To observe the thrombolysis efficacy of actilyse recombinant tissue plasminogen activactor (rtPA) and urokinase (UK) on cute myocardial infarction (AMI).Methods:Eighty patients with AMI were randomly divided into 2 groups.Group A ( n =38) was treated with rtPA and group B ( n =42) was treated with UK.Results:The average repatency rates of the coronary vessel in 80 cases was 60 0%.The repatency rates the coronary vessel were 73 6% and 47 6% in group A and group B.They have obvious difference ( P <0 01).The mortalities were 5 3% and 11 9% in group A and group B respectively,and they have no significant difference ( P >0 05).The incidence of subsequent visceral hemorrhage in group A(0) was obviously lower than that in group B (14 3%, P <0 01),and the mortality in patients with coronary repatency (0) was lower than that in patients without coronary repatency (21 9%, P <0 01).The vassel repantency rate was 78 3% in patients attacted within 6 hours,it was obviously higher than that in patients attacted wthin 6 to 24 hours (35 3%, P <0 01).Conclusions:rtPA has a better clinical effect than UK in instantly thrombolysis in AMI with less sideeffects.