依诺肝素联合瑞替普酶和尿激酶治疗AMI的疗效与安全性观察

Observation on the efficacy and safety of enoxaparin combined with reteplase and urokinase in treatment of AMI

目的观察依诺肝素联合瑞替普酶及尿激酶治疗AMI的疗效与安全性。方法选择我院2012年8月-2014年8月收治的95例急性心肌梗死患者展开研究,按照随机数字表法分为A组(n=48)与B组(n=47)。A组应用依诺肝素联合瑞替普酶治疗,B组应用依诺肝素联合尿激酶,比较两组血管再通率、并发症发生率与转归情况。结果 A组溶栓30 min血管再通率与B组接近(P>0.05);溶栓60 min、120 min时血管再通率均高于B组,差异有统计学意义(P<0.05);两组死亡率分别为2.0%、6.4%,差异无统计学意义(P>0.05);A组并发症发生率为8.4%,低于B组25.5%,差异有统计学意义(P<0.05)。A组IRA开通时间短于对照组,差异有统计学意义(P<0.05);两组CK-峰值时间、CK-MB峰值时间比较差异无统计学意义。结论瑞替普酶治疗急性心肌梗死安全性高,且溶栓活性高,血管再通率明显高于尿激酶,为理想溶栓药物,值得借鉴。

【Objective】To observe the efficacy and safety of enoxaparin combined with reteplase and urokinase in the treatment of AMI. 【Methods】95 patients with acute myocardial infarction admitted into the hospital from August 2012 to August 2014 were studied and divided into group A（n=48） and group B（n=47） by random number table. Group A was given enoxaparin combined with reteplase therapy while group B was given enoxaparin combined with urokinase. The recanalization rate of blood vessels, the incidence of complications and the state of prognosis in two groups were compared. 【Results】The recanalization rate of blood vessels in group A after 30 min of thrombolytic was close to that of group B（P〈0.05）; After 60 min and 120 min of thrombolytic, the recanalization rate was higher than that of group B and the difference was statistically significant（P〈0.05）. The incidence of complications and mortality of group A were 20.8% and 2.0% and there was no significant difference compared with B group（P〈0.05）. 【Conclusion】Reteplase and urokinase in treatment of acute myocardial infarction is of high safety, but reteplase is of better thrombolytic activity which improves the recanalization rate. It is ideal thrombolytic drugs, worthy of reference.