瑞替普酶治疗急性心肌梗死的疗效探讨

Observation of the Clinical Effects of Reteplase(rPA) in the Treatment of Acute Myocardial Infarction(AIM)

目的评价瑞替普酶和尿激酶治疗急性心肌梗死(acute myocardial infarction,AMI)的疗效性和安全性。方法随机选取2012年1月—2013年12月北京市多家医院急诊室治疗的AMI患者120例,随机分为瑞替普酶组和尿激酶组,均无溶栓禁忌症,在常规治疗基础上分别给予瑞替普酶和尿激酶。比较两组的临床疗效、并发症发生率及溶栓后再通率。结果瑞替普酶组总有效率(86.67%)明显高于尿激酶组(71.67%),差异具有统计学意义(P<0.05)。两组治疗后30 min和120 min溶栓后再通率比较差异无统计学意义(P>0.05),而60 min和90 min溶栓后再通率明显高于尿激酶组,差异均具有统计学意义(P<0.05)。瑞替普酶组和尿激酶组的出血发生率分别为6.67%和18.33%,差异具有统计学意义(P<0.05)。结论与尿激酶相比,瑞替普酶治疗AMI,溶栓后再通率迅速、并发症少、临床疗效高。

Objective To explore the clinical effects and security of reteplase(r PA) and urokinase(UK) in the treatment of AIM.Methods A total of 120 patients with AIM after emergency operation from 2012 January to 2013 December were randomly divided into group r PA and group UK, which all have no contraindications to thrombolysis. Patients in group r PA and group UK were given separately r PA and UK except routine therapy. Clinical effects, complication rate and recanalization rate after thrombolytic treatment were analyzed. Results The total effective rate of group r PA(86.67%) was obviously higher than of group UK(71.67%)(P<0.05). The statistically significant different of the recanalization rate was noticed in 30 minutes compared with 120 minutes after thrombolytic treatment(P<0.05). However, it was not clear that the recanalization rate in 60 minutes after thrombolytic treatment compared with 90 minutes(P >0.05). The rate of hemorrhage was significantly decreased in r PA group(6.67%) compared with group UK(18.33%)(P<0.05). Conclusion Compared with UK, r PA has good curative effect with AMI and are less complications.Besidesthe recanalization rate of r PA was higher after thrombolytic treatment.