瑞替普酶与尿激酶在急性心肌梗死溶栓再灌注治疗中疗效对比

Comparison of reteplase and urokinase in treatment of thrombolysis reperfusion in acute myocardial infarction patients

目的探讨瑞替普酶和尿激酶在急性心肌梗死溶栓再灌注治疗中的临床效果差异。方法随机选取灵宝市第一人民医院2012年8月至2014年7月期间收治的急性心肌梗死患者90例，所有患者均进行溶栓再灌注治疗，按照溶栓药物的不同将其分为观察组和对照组，其中观察组患者采用瑞替普酶进行溶栓治疗，对照组患者采用尿激酶进行治疗，对两组患者的临床治疗效果及其并发症的发生情况进行记录分析。结果实验组患者的溶栓再通成功率明显高于对照组，差异具有统计学意义（P〈0．05）；除出血率外，两组患者再梗死、休克、心力衰竭等并发症的发生率及病死率差异未见统计学意义（P〉0．05）。结论同尿激酶相比，采用瑞替普酶进行急性心肌梗死溶栓再灌注治疗，能够有效增强溶栓效果，且出血率低，安全性好，建议在临床上进一步推广使用。

Objective To investigate the differences of efficacy of reteplase and urokinase on acute myocardial infarction patients. Methods Ninety cases of acute myocardial infarction in the first people＇ s hospital of Lingbao from August 2012 to July 2014 were randomly selected. All patients underwent thrombolysis reperfusion. According to different thrombolytic drugs, the 90 cases were divided into observation group and control group. Observation group underwent thrombolytic therapy by reteplase, while control group underwent thrombolytic therapy by urokinase. Clinical therapeutic effect and occurrence of complications of patients of two groups were recorded and analyzed. Results Success rate of thrombolytic recanalization in experiment group patients was significantly higher than the control group, the difference was significant （ P 〈 0. 05 ）. In addition to bleeding rate, there were no significant differences between the two groups in occurrence rate and fatality of complications such as reinfarction, shock and heart failure （P 〉 0. 05 ）.Conclusions Compared with urokinase, using reteplase thrombolytic reperfusion therapy for acute myocardial infarction, it can effectively enhance effect of thrombolysis, reduce bleeding rate and has good security of using reteplase in thrombolysis reperfusi for acute myocardial infarction, so it is suggested to be further popularized clinically.