注射用瑞替普酶治疗急性ST段抬高型心肌梗死的疗效评价

Evaluation of Therapeutic Effect of Reteplase for Injection on Acute ST-segment Elevation Myocardial Infarction

目的探讨注射用瑞替普酶治疗急性ST段抬高型心肌梗死的临床疗效。方法选择我院收治的90例急性ST段抬高型心肌梗死患者(2018年1月至2019年1月),随机划分为2组各45例,对照组给予尿激酶静脉溶栓,观察组给予注射用瑞替普酶静脉溶栓,比较血管再通率、TIMI血流分级、心肌酶指标、血液流变学指标、不良事件发生率。结果观察组在溶栓后90 min、120 min时的血管再通率均较对照组更高(P<0.05),其TIMI 3级血流占比较对照组更高(P<0.05)。治疗后,观察组的心肌酶指标、血液流变学指标均较对照组更低(P<0.05)。两组不良事件发生率比较,差异均无统计学意义(P>0.05)。结论注射用瑞替普酶进行静脉溶栓治疗,可有效改善急性ST段抬高型心肌梗死患者的心肌血流灌注,使其血管恢复通畅,且不良事件少,安全性良好。

Objective To investigate the clinical effect of reteplase for injection in the treatment of acute ST-segment elevation myocardial infarction.Methods 90 patients with acute ST-segment elevation myocardial infarction(January 2018-January 2019)were selected and randomly divided into two groups,45 patients in each group.The control group received intravenous thrombolysis with urokinase,while the observation group received intravenous thrombolysis with reteplase for injection.Vascular recanalization rate,TIMI blood flow grading,myocardial enzyme index,hemorheological index and incidence of adverse events were compared.Results The vascular recanalization rate of the observation group at 90 min and 120 min after thrombolysis was higher than that of the control group(P<0.05),and the proportion of TIMI grade 3 blood flow was higher than that of the control group(P<0.05).After treatment,the indexes of myocardial enzymesand Hemorheology in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion Intravenous thrombolytic therapy with reteplase for injection can effectively improve myocardial perfusion in patients with acute ST-segment elevation myocardial infarction,and make the blood vessel recover smoothly,with fewer adverse events and good safety.