国产重组链激酶、尿激酶对急性心肌梗死溶栓的疗效分析

Comparison the effects of recombinant streptokinase and urokinase in acute myocardial infarction

目的 观察国产重组链激酶 (r-SK)和尿激酶 (UK)对急性心肌梗死 (AMI)溶栓的效果和不良反应。方法 自 2 0 0 1年 1月 - 2 0 0 3年 12月对 10 0例AMI患者随机分成两组 ,每组各 5 0例 ,一组予 15 0万单位r -SK溶栓 ,另一组予 15 0万单位UK溶栓治疗 ,观察两组溶栓再通率、急性期死亡率、并发症以及不良反应发生率。结果 (1)溶栓再通率r-SK组为 82 .0 % ,UK组为 6 4 .0 % ,r-SK组明显优于UK组 (P <0 .0 5 ) ;(2 ) 6小时内溶栓再通率r-SK组为 85 .7% ,UK组为 6 5 .8% ,两组间有显著差异 (P <0 .0 5 ) ;(3)发病 6小时以上溶栓再通率 ,r -SK组6 2 .5 % ,UK组为 5 5 .6 % ,两组无显著差异 (P >0 .0 5 ) ;(4 )两组间在 35天死亡率及皮肤黏膜轻度出血等方面无显著差异 ,无脑出血及严重出血发生 ;(5 )r-SK组一过性低血压发生率高于UK组 (14 .0 %和 4 .0 % ) ,但两组间无显著差异 (P >0 .0 5 ) ;(6 )r-SK组的过敏反应发生率为 4 .0 % ,UK组为 0 .0 %。结论 r-SK和UK都是治疗AMI的疗效肯定、安全的溶栓药物 ,r-SK的疗效明显优于UK ,溶栓时间越早其再通率越高。

Objective To observe and compare the clinical efficacy and adverse reaction using recombinant streptokinase(r-SK) and urokinase(UK) in acute myocardial infarction(AMI) respectively.Methods 100 patients were divided into two groups with each of 50 patients.one group were treated by r-SK(1.5MU) and the other group were treated by UK(1.5MU). Percentage of reperfusion,mortality and adverse reaction rate were compared between two groupe.Results (1) The reperfusion rate of r-SK and UK was 82.0% and 64.0%(P<0.05), respectively; (2) The reperfusion rate within 6 hours in r-SK group was 85.7%, while UK group was 65.8% (P<0.05) ; (3) There was no significant difference in the rate of reperfusion 6 hour later between tow groups,62.5% and 55.6%(P>0.05);(4)There was no significant difference between r-SK group and UK group on 35-day mortality,intracranial hemorrhage was not observed in both groups.Slight bleeding was not different between two groups;(5)Hypotension in r-SK was 14.0% while in UK was 4.0% (P>0.05);(6) Allergic reaction in r-SK group was 4.0%,but not observed in UK group.Conclusions Both recombinant Streptokinase and Urokinase were effective, reliable and safe thrombolytic agent. However, recombinant Streptokinase showed signicant clinical efficacy than that of Urokinase in early reperfusion rate.