爱通立治疗急性ST段抬高型心肌梗死的疗效分析

Effect analysis of ST-segment elevation acute myocardial infarction by alteplase treatment

目的：探讨半剂量和全剂量重组人组织型纤溶酶原激活物（rtPA）溶栓药物爱通立治疗急性ST段抬高型心肌梗死（STEMI）的疗效。方法将216例STEMI患者根据给药方法不同分为半剂量组（n＝118）和全剂量组（n＝98），观察两组患者的冠状动脉血管再通率、出血不良反应、明显心律失常发生率。结果治疗后，半剂量组和全剂量组血管再通率分别78．4％（92／118）、83．3％（81／98），差异有统计学意义（P＜0．05）。两组出血不良反应及明显心律失常发生率差异无统计学意义（P＞0．05）。STEMI发病后3h内、3～6h、＞6～12h给予rtPA溶栓治疗的患者血管再通率分别为91．2％、73．9％、53．80％。结论rtPA治疗STEMI的疗效肯定，安全可靠，尤其适用于无条件进行介入治疗的基层医院。

Objective To investigate the effect of half dose and full dose of alteplase as human recombinant tissue type profibrinolysin activator（rtPA） thrombolytic drug in treating ST‐segment elevation myocardial infarction （STEMI） .Methods 216 cases of STEMI were divided into the half dose group（n= 118） and the full dose group（n=98） according to the administration methods .The coronary artery recanalization rate ,bleeding adverse reaction and occurrence rate of obvious arrhythmia were observed and compared between the two groups .Results The coronary artery recanalization rates after treatment in the half dose group and the full dose group were 78 .4 % （92/118） and 83 .3% （81/98） respectively ,and the difference was statistically significant （P 〈 0 .05） .But the occurrence rates of bleeding and obvious arrhythmia had no statistical difference between the two groups（P〉 0 .05） .The rates of coro‐nary artery recanalization in the patients treated by the rtPA thrombolytic treatment within 3 ,3 - 6 ,〉 6 - 12 h after STEMI onset were 91 .2% ,73 .9% and 53 .80% respectively .Conclusion The rtPA therapy is effective ,safe and re‐liable for treating STEMI ,especially suitable for the primary hospital without condition for conducting intervention treatment .