瑞替普酶在急性ST段抬高型心肌梗死抢救中的应用体会

APPLICATION ANALYSIS OF RETEPLASE IN THE RESCUE OF ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

目的比较分析瑞替普酶(reteplase,r-PA)与尿激酶(urokinase,UK)静脉溶栓在急性ST段抬高型心肌梗死(ST-segment acute myocardial infarction,STEMI)抢救中的效果和安全性。方法选择2006年6月—2009年6月收治的AMI患者116例,随机分为UK治疗组和r-PA治疗组各58例,观察2组患者溶栓再通时间、住院时间、再通率、ST段回落率、出血发生率、急性期病死率等。结果 6、12h再通率r-PA治疗组分别为86.21%、89.66%,UK治疗组为72.41%、77.59%,2组比较差异有统计学意义(P<0.05)。2组之间的出血率、急性期病死率、ST段回落率差异均有统计学意义(P<0.05)。r-PA治疗组和UK治疗组住院时间分别为(8.25±1.08)d、(8.48±1.55)d,差异无统计学意义(P>0.05)。结论 r-PA对AMI的溶栓总体效果优于UK,可以有效减少出血率并缩短溶栓时间,且r-PA具有给药方便的优点,是一种比较安全有效的溶栓药物。

Objective To compare the efficacy and safety of reteplase （r- PA） and urokinase （UK） in the treatment of the acute ST -segment elevation myocardial infarction （STEMI）. Methods One hundred and sixteen patients with STEMI during the period from 2006 to 2009 were randomly divided into r - PA group （ n = 58） and UK group （ n = 58）. The reeanalization rate, hospitalization time, rate of ST- segment resolution, hemorrhage rate, and mortality of acute stage were observed. Results The recanalization rates were obviously different between r- PA and UK group （86.21% vs 72.41% at 6h; 89.66% vs 77.59% at 12h）; hemorrhage rate, mortality, and rate of ST- segment resolution were shown sigffificant differences between the two groups （ P 〈 0.05 ） , and there was no difference between the hospitalization time of the two groups[ （8.25 ± 1.08） d vs （8.48 ± 1.55 ） d, P 〉 0.05 ]. Conclusion Reteplase is better than UK in the treatment efficacy of the acute STEMI and is an effective and safe thrombolytie agents.