小剂量重组组织型纤溶酶原激活物与重组链激酶治疗急性心肌梗死的对比研究

Comparion of intravenous thrombolytic therapy with low dose recombinant tissue type plasminogen activator(r-TPA) and recombinant strepokinase(r-SK) in patients with acute myocardial infarction

目的 评价小剂量重组组织型纤溶酶原激活物 (r-TPA)与国产重组链激酶 (r-SK)治疗急性心肌梗死 (AMI)的疗效 ,并比较二者的差异。方法 71例AMI患者 ,均采用静脉溶栓 ,随机分为r -TPA治疗组 (36例 )和r-SK治疗组 (35例 )。结果 梗死相关血管再通率r-TPA组为 77 78% (2 8/ 36 ) ,r-SK组为 74 2 9% (2 6 / 35 ) ,P >0 0 5 ,差异不显著 ;4周病死率r-TPA组为 5 5 6 % (2 / 36 ) ,r-SK组为 5 71(2 / 35 ) % ,差异不显著 (P >0 0 5 ) ;两组均未出现严重出血。但r-SK组过敏反应发生率为 8 5 7% (3/ 35 ) ,低血压发生率为 2 86 % (1/ 35 )。结论 加速法使用国产r -SK治疗AMI,梗死相关血管再通率、4周病死率r-TPA与r-SK相似 ,但过敏反应及低血压发生率r-SK较r-TPA高 ,国产r-SK治疗AMI安全有效 ,无严重出血 ,费用较r-TPA低 ,值得临床推广使用。

Objective To evaluate the clinical efficacy and safety of intravenous thrombolytic therapy using low dose recombinant tissue plasminogen activator(r-TPA) and recombinant strepokinase(r-SK) in patients with acute myocardial infarction (AMI). Methods 71 patients were divided into r-TPA group (36 cases) and r-SK group (35 cases). Results The reperfusion rates of infarct-related arteries in r-TPA and r-SK groups were 77.78%(28/36) and 74.29%(26/35), P >0.05. The total 4-week mortality in r-TPA and r-SK groups were 5.56%(2/36) and 5.71%(2/35), P >0.05. Two groups had no severe bleeding. Conclusion The r-SK is effective, reliable and safe thrombolytic agents for AMI.