瑞替普酶治疗急性ST段抬高心肌梗死临床疗效观察

Therapeutic Effect of Reteplase on ST-segment Elevation Myocardial Infarction

目的观察基层医院应用瑞替普酶对急性ST段抬高心肌梗死治疗的临床疗效及安全性.方法将2011年1月至2013年12月屯留县人民医院收治的95例符合溶栓治疗的急性ST段抬高心肌梗死患者分为2组:瑞替普酶组(54例)和尿激酶组(41例).瑞替普酶组患者给予瑞替普酶18 mg静脉滴注,30 min后重复上述剂量1次,尿激酶组患者给予尿激酶150万U溶栓,30 min内静滴完成.比较2组的溶栓冠脉再通率、心血管并发症、再闭塞、出血、死亡率.结果瑞替普酶与尿激酶组比较,血管再通率差异有统计学意义(P<0.05).2组心血管并发症、再闭塞、出血、死亡率差异无统计学意义.结论瑞替普酶治疗急性ST段抬高心肌梗死冠脉再通时间早、冠脉再通率高、给药方便、药物维持时间长、不良反应少,是一种高效而安全的溶栓药物.

Objective To evulate the therapeutic effect and safety of reteplase in treatment of ST-segment elevation myocardial infarction.Methods Ninety-five patients with ST-segment elevation myocardial infarction who admitted in our hospital from January 2011 to December 2013 were divided into 2 groups： reteplase group（54cases） and urokinase group（41 cases）. Patients in reteplase group were intravenous injection of 18 mg of reteplase for twice, and the interval was 30 minute, and patients in urokinase group were given intravenous injection of1500,000 U urokinase in 30 minutes. The recanalization rate of coronary artery, the incidence of cardiovascular complications, reocclusion, hemorrhage and mortality were compared between two groups. Results There was statistically significant difference in the recanalization rate of coronary artery between two groups（P〈0.05）. There were no statistically significant differences in the incidence of cardiovascular complications, reocclusion,hemorrhage and mortality between two groups（P〉0.05）. Conclusion Reteplase is a highly active and safe thrombolytic drug in treatment of ST-segment elevation myocardial infarction with earlier recanalization,higher recanalization rate of coronary artery,more convenient administration way,longer maintaining time and less adverse reactions.