摘要
目的:探讨阿替普酶治疗对急性ST段抬高型心肌梗死(STEMI)的窦性心率震荡的影响。方法:68例STEMI患者按数字表法被随机均分为尿激酶组(34例)和阿替普酶组(34例)。检测24h动态心电图,分析计算窦性心率震荡[震荡初始(TO)、震荡斜率(TS)]。统计临床溶栓再通率及再通时间、胸痛症状缓解率以及终点事件。结果:与尿激酶组比较,阿替普酶组再通率(52.9%比73.5%)、胸痛症状缓解率(55.9%比82.4%)及TS[(5.50±2.11)ms/RR比(8.69±3.82)ms/RR]均显著升高,TO[(2.34±0.28)%比(0.75±0.04)%]明显降低,P<0.05或<0.01;与尿激酶溶栓再通亚组比较,阿替普酶溶栓再通亚组溶栓再通时间[(183.1±62.9)min比(120.6±54.8)min]显著减少、TO[(1.16±0.13)%比(0.32±0.06)%]显著降低,TS[(8.42±2.93)ms/RR比(12.13±4.65)ms/RR]显著升高,P<0.05或<0.01。结论:阿替普酶治疗急性ST段抬高型心肌梗死的临床疗效较尿激酶明显,能有效改善窦性心率震荡。
Objective： To explore influence of alteplase on sinus heart rate turbulence （HRT） in patients with acute ST-segment elevation myocardial infarction （STEMI） and its therapeutic effects. Methods： A total of 68 STEMI patients were randomly divided into urokinase group （n = 34） and alteplase group （n = 34） according to number table. The 24h ambulatory electrocardiography was measured, and then sinus HRT [turbulence onset （TO）and turbulence slope （TS）] was calculated and analyzed; clinical thrombolysis recanalization rate etc. was statistically counted in all patients. Results： Compared with urokinase group, there were significant increase in reeanalization rate （52.9 % vs： 73.5%）, remission rate of chest pain （55.9% vs. 82.4%） and TS [ （5.50 ±2.11） ms/RR vs. （8. 69 ±3. 82） ms/ RR], and significant decrease in TO [ （2.34 ±0.28） % vs. （0.75 ±0.04） %] in alteplase group, P〈0.05 or 〈0.01 ; compared with recanaUzation subgroup of urokinase, there were significant decrease in thrombolysis recanalization time [ （183.1 ±62.9） min vs. （120.6 ±54. 8） mini and T0 [ （1.16 ±0.13） % vs. （0.32 ±0.06） %], and significant increase in TS [ （8.42 ±2.93） ms/RR vs. （12.13 ±4. 65） ms/RR] in recanalization subgroup of alteplase group, P 〈0. 05 or 〈0. 01. Concision： Alteplase possesses significant clinical therapeutic effect for acute ST-segment elevation myocardial infarction and can effectively improve sinus heart rate turbulence.
出处
《心血管康复医学杂志》
CAS
2013年第6期595-598,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
