重组组织型纤溶酶原激活剂在急性心肌梗死治疗中的效果研究

Effect study of recombinant tissue plasminogen activator in the treatment of acute myocardial infarction

目的探究急性心肌梗死(AMI)患者应用重组组织型纤溶酶原激活剂(rt-PA)治疗的临床效果。方法选择80例AMI患者,依据随机原则分为对照组和观察组,各40例。对照组接受尿激酶溶栓治疗,观察组接受rt-PA治疗。比较两组临床疗效、血清指标[肌酸激酶同工酶(CK-MB)、超敏肌钙蛋白I(hs-cTnI)、肌红蛋白(Mb)、氨基末端脑利钠肽前体(NT-proBNP)]、心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、预后情况。结果观察组治疗总有效率92.50%高于对照组的75.00%(P<0.05)。治疗前,两组CK-MB、hs-cTnI、Mb、NT-proBNP比较无差异(P>0.05);治疗后,观察组CK-MB(43.41±10.39)U/L、hs-cTnI(9.85±2.26)ng/ml、Mb(158.43±18.19)μg/L、NT-proBNP(903.89±122.15)pg/ml均低于对照组的(54.58±9.58)U/L、(15.43±2.67)ng/ml、(245.68±23.85)μg/L、(1215.46±233.89)pg/ml(P<0.05)。治疗前,两组LVEF、LVESD、LVEDD比较无差异(P>0.05);治疗后,观察组LVEF(74.78±4.35)%大于对照组的(65.72±2.87)%,LVESD(31.37±1.89)mm、LVEDD(49.32±1.79)mm小于对照组的(36.74±2.27)、(55.25±2.26)mm(P<0.05)。两组死亡率、生存率比较无差异(P>0.05);观察组不良心血管事件发生率低于对照组(P<0.05)。结论针对AMI患者,临床治疗时采用rt-PA,可明显提升临床效果,改善心肌酶学、心功能相关指标,且对不良心血管事件的控制也有较突出作用。

Objective To explore the clinical effect of recombinant tissue plasminogen activator(rt-PA)in the treatment of acute myocardial infarction(AMI).Methods 80 patients with AMI were selected and randomly divided into a control group and an observation group,with 40 patients in each group.The control group received urokinase thrombolytic therapy,and the observation group received rt-PA therapy.Both groups were compared in terms of clinical efficacy,serum indexes[creatine kinase isoenzyme(CK-MB),hypersensitive cardiac troponin I(hs-cTnI),myoglobin(Mb),N-terminal pro-brain natriuretic peptide(NT-proBNP)],cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),and left ventricular diastole(LVEDD)]and prognosis.Results The total effective rate of the observation group was 92.50%,which was higher than 75.00%of the control group(P<0.05).Before treatment,there was no difference in CK-MB,hs-cTnI,Mb and NT-proBNP between the two groups(P>0.05).After treatment,the observation group had CK-MB of(43.41±10.39)U/L,hs-cTnI of(9.85±2.26)ng/ml,MB of(158.43±18.19)μg/L and NT-proBNP of(903.89±122.15)pg/ml,which were lower than(54.58±9.58)U/L,(15.43±2.67)ng/ml,(245.68±23.85)μg/L,(1215.46±233.89)pg/ml in the control group(P<0.05).Before treatment,there were no differences in LVEF,LVESD and LVEDD between the two groups(P>0.05).After treatment,LVEF of the observation group was(74.78±4.35)%,which was higher than(65.72±2.87)%of the control group;the observation group had LVESD of(31.37±1.89)mm and LVEDD of(49.32±1.79)mm,which were smaller than(36.74±2.27)and(55.25±2.26)mm of the control group(P<0.05).There was no difference in death rate and survival rate between the two groups(P>0.05).The incidence of adverse cardiovascular events in the observation group was lower than that in the control group(P<0.05).Conclusion For AMI patients,rt-PA in clinical treatment can significantly improve the clinical effect,myocardial enzymology and cardiac function related indicators,and also play a prominent role in the control of adverse cardiovascular events.