瑞替普酶与尿激酶静脉溶栓治疗ST段抬高型心肌梗死的疗效

Effects of intravenous thrombolytic therapy with reteplase and urokinase on ST-segment elevation myocardial infarction

目的探讨瑞替普酶与尿激酶静脉溶栓治疗ST段抬高型心肌梗死患者(STEMI)的疗效。方法将本院收治的60例STEMI患者随机分为试验组和对照组,各30例。对照组给予尿激酶,试验组给予瑞替普酶。比较两组患者不同时间点的血管再通率,溶栓治疗后6、12 d血清MMP-1、TIMP-1水平,治疗前、后心功能及并发症发生情况。结果试验组溶栓治疗后60、90、120 min的血管再通率均显著高于对照组(P<0.05);溶栓治疗后6、12 d,两组患者血清MMP-1、TIMP-1水平均显著下降,试验组显著低于对照组(P<0.05);溶栓后6 d,试验组患者左室射血分数(LVEF)、心输出量(CO)均上升,且显著高于对照组(P<0.05);对照组出血发生率显著高于试验组(P<0.05)。结论瑞替普酶可显著降低STEMI患者的MMP-1、TIMP-1水平,可改善患者心功能,值得推广。

Objective To investigate the effect of intravenous thrombolytic therapy with reteplase and urokinase on ST-segment elevation myocardial infarction （STEMI） patients. Methods A total of 60 STEMI patients admitted in our hospitalwere randomly divided into experimental group and control group, with 30 cases in each group. The control group was givenurokinase, and the experimental group was given reteplase. The vessel repass rates at different time points, serum MMP-1and TIMP-1 levels after thrombolysis treatment 6 and 12 d, the heart function before and after treatment and occurrences ofcomplications between the two groups were compared. Results The vessel repass rates in the experimental group weresignificantly higher than those in the control group at 60, 90 and 120 min after thrombolytic therapy （P〈0.05）. At 6 and 12dafter thrombolytic treatment, the serum levels of MMP-1 and TIMP-1 decreased significantly in the two groups, and thosein the experimental group were significantly lower than the control group （P〈0.05）. At 6d after thrombolytic treatment leftventricular ejection fraction （LVEF）, cardiac output （CO） in the experimental group significantly increased, and those weresignificantly higher than the control group （P〈0.05）. The incidence of hemorrhage in the control group was significantlyhigher than that in the experimental group （P〈0.05）. Conclusion Reteplase can significantly reduce the levels of MMP-1and TIMP-1 in patients with STEMI, improve the cardic function, which is worthy of promotion.