瑞替普酶院前溶栓治疗急性ST段抬高性心肌梗死临床疗效及安全性观察

目的观察瑞替普酶院前溶栓治疗急性ST段抬高性心肌梗死患者的临床疗效及安全性。方法回顾分析2010年9月-2012年12月收治的62例急性ST段抬高性心肌梗死患者，随机分为两组，其中院前组22例于120救护车上和（或）急诊科进行瑞替普酶溶栓，院内组40例于入院后进行溶栓治疗，比较两组溶栓治疗后60、120min再通率，并发各种不良反应发生率及复合终点事件发生率。结果溶栓后60、120min院前组临床判断再通率均明显高于院内组（P〈0．05），住院4周内并发各种出血、心力衰竭、低血压及死亡发生率两组差异无统计学意义（P〉0．05）。结论瑞替普酶院前溶栓治疗急性ST段抬高性心肌梗死具有更好的临床疗效及安全性，值得基层医院临床推广。

Observation of the Clinical Efficacy and Safety of Reteplase in Prehospital Thrombolysis for ST-segment Elevation Acute Myocardial Infarction

Objective To observe the clinical efficacy and safety of reteplase in prehospital thrombolysis for ST- segment elevation acute myocardial infarction. Methods We retrospectively analyzed the clinical data of 62 patients with acute ST-segment elevation myocardial infarction treated in our hospital between September 2010 and December 2012. They were randomly divided into two groups： the treatment group with 22 patients given reteplase thrombolysis therapy in the prehospital ambulance and/or emergency department, and the control group with 40 patients receiving thrombolytic therapy in the hospital. Then, we compared 60-minute and 120-minute recanalization rate, the rate of complicating with various kinds of adverse reactions and the composite end-point event rate between the two groups. Results Sixty minutes and 120 minutes after thrombolysis, the clinical judgment recanalization rate in the treatment group was significantly higher than that in the control group （P 〈 0.05）. Four weeks after hospitalization, the rate of complicating with various kinds of hemorrhage, hypotension and death rate in the two groups had no statistical difference （P 〉 0.05）. Conclusion Prehospital thrombolysis treatment for ST-segment elevation acute myocardial infarction has a better clinical efficacy and is worth popularizing in basic unit hospitals.