不同溶栓剂治疗急性心肌梗死的临床比较

Clinical comparison of different thrombolytic agents in treatment of acute myocardial infarction

目的：比较尿激酶、瑞替普酶治疗急性心肌梗死的临床疗效。方法以运城市中心医院2013年1月至2014年10月收治的62例急性心肌梗死患者为研究对象，均行早期溶栓治疗，其中尿激酶用药32例，为A组，瑞替普酶用药30例，为B组，比较两组血管再通率、出血并发症及终点事件等情况。结果 A组6 h、12 h内血管再通率分别为53.1％、75.0％，出血并发症发生率为25.0％，与B组的80.0％、93.3％、6.7％比较差异有统计学意义（P＜0.05）。另外，30 d内两组心源性休克、心力衰竭、再梗死、死亡各终点事件发生率比较差异未见统计学意义（P＞0.05）。结论相比尿激酶，瑞替普酶溶栓具有再通率高、出血并发症发生率低的特点，可作为急性心肌梗死治疗的重要溶栓手段。

Objective To compare the clinical effect of urokinase , reteplase on acute myocardial infarction .Methods Sixty-two patients with acute myocardial infarction were treated in Yuncheng central hospital from January 2013 to October 2014 were selected as the research objects , they were all underwent thrombolytic therapy , including 32 cases of urokinase medication as group A , 30 cases of reteplase medication as group B , the vascular recanalization rate , bleeding complications and end events of two groups were compared.Results In group A, the inner vessel recanalization rate in 6 h, 12 h was 53.1%, 75.0%, and the complication rate was 25.0%, that of group B was 80.0%, 93.3%, 6.7%（P〈0.05）.In addition, the cardiogenic shock , heart failure , myocardial infarction , death the end event rate of the two groups in 30 d had no significant difference （ P〉0.05 ） .Conclusions Compared with urokinase , thrombolysis with reteplase has advantages as low recanalization rate and low complication rate , it can be used as thrombolytic therapy in patients with acute myocardial infarction .