急性心肌梗死溶栓药物疗效的循证医学评价

根据大量临床试验结果对治疗急性心肌梗死(AMI)的溶栓药物从疗效、并发症等进行了比较,发现溶栓药物从第1代到第3代在纤维蛋白选择性、半衰期、给药方式等方面有了较大的改进,使AMI的病死率降至7%~8%,但新型溶栓药物在有效率方面并没有明显超过组织型纤溶酶原激活剂,仍存在着颅内出血并发症、价格昂贵等缺点。因此,积极联用抗栓药物和经皮冠状动脉介入术治疗AMI,乃是降低病死率的倡用办法。

Evaluation of Evidence-Based Medicine on the Therapeutic Effect of Thrombolytic Drugs Treating Acute Myocardial Infarction

Different types of thrombolytic drugs for acute myocardial infarction were compared in terms of therapeutic effect, half-life, antigenicity, hemaleucin selectivity, and complications based on evidence from clinical trials. It was found that, compared with the first generation of thrombolytic drugs, the third generation had improved substantially in terms of hemaleucin selectivity, half-life, administration method and other aspects, which contribute to a reduction of the mortality rate of AMI of 7% or 8%. Evidence from clinical trials also indicated that these thrombolytic drugs, developed in the past few years, were still not as effective as t-PA. Other issues of concern are complications of intracranial haemorrhage, antigenicity and high cost. A combination of antithrombotic drugs and PCI might be an optimal choice to treat AMI to reduce mortality.