瑞替普酶、尿激酶静脉溶栓治疗急性心肌梗死的临床效果对比

Comparison on the Clinical Effects of Intravenous Thrombolysis of Reteplase and Urokinase in the Treatmen of Acute Myocardial Infarction

目的分析瑞替普酶、尿激酶静脉溶栓治疗急性心肌梗死(AMI)的临床效果。方法将90例AMI患者随机分为观察组(n=45)和对照组(n=45)。对照组予以尿激酶静脉溶栓治疗,观察组予以瑞替普酶静脉溶栓治疗,随后两组均予以低分子肝素治疗。比较两组的冠脉再通率、心肌酶水平和不良反应发生率。结果治疗后30 min、60 min、90 min、120min,观察组冠脉再通率高于对照组(P<0.05)。治疗5d后,观察组cTnT水平高于对照组,CK-MB水平低于对照组(P<0.05)。治疗期间,观察组不良反应发生率为6.67%,与对照组的8.89%比较无统计学差异(P>0.05)。结论与尿激酶静脉溶栓治疗相比,瑞替普酶静脉溶栓治疗可明显提高AMI患者的冠脉再通率,降低心肌酶水平,而安全性相当。

Objective To analyze the clinical effect of intravenous thrombolysis of reteplase and urokinase in the treatment of acute myocardial infarction(AMI).Methods 90 AMI patients were randomly divided into observation group(n=45)and control group(n=45).The control group was given intravenous thrombolysis of urokinase,and the observation group was given intravenous thrombolysis of reteplase.Then both groups were treated with low molecular weight heparin.The coronary recanalization rate,myocardial enzyme level and the incidence of adverse reactions were compared between the two groups.Results 30 min,60 min,90 min and 120 min after treatment,the coronary recanalization rate of the observation group was higher than that of the control group(P<0.05).After 5 days of treatment,the cTnT level of the observation group was higher than that of the control group,and the CK-MB level was lower than that of the control group(P<0.05).No statistical difference was found in the incidence of adverse reactions(6.67%vs.8.89%)during treatment between the two groups(P>0.05).Conclusions Compared with intravenous thrombolysis of urokinase,intravenous thrombolysis of reteplase can significantly improve the coronary recanalization rate and reduce the myocardial enzyme level in AMI patients,with equivalent safety.