重组组织型纤溶酶原激活剂静脉溶栓治疗急性心肌梗死23例临床分析

目的观察重组组织型纤溶酶原激活剂(recombinant tissue—type plasminogen activator，rt—PA)静脉溶栓治疗急性心肌梗死的疗效，探讨溶栓时间窗。方法23例心肌梗死患应用rt—PA静脉溶栓治疗，通过观察临床症状、心电图、心肌酶谱的变化，判断冠状动脉再通率，并观察出血的发生率及严重程度。结果23例患溶栓后冠状动脉再通17例，其中，发病6小时内13例溶栓冠状动脉再通11例，发病6～12小时内10例溶栓冠状动脉再通6例；1例再通24小时发生再梗死；2例出现牙龈出血；1例出现皮下出血。结论rt—PA静脉溶栓治疗心肌梗死在发病6小时内应用疗效显，发病6～12小时应用仍然有效。

Clinical analysis of treatment of acute myocardial infarction with recombinant tissue-type plasminogen activator: report on 23 cases

Objestives To observe the efficacy of intovenous recombinant tissue-type plasminogen activator (rt-PA) in treatment of acute myocardial infarction (AMI)and to determine the time therapeutic windows. Methods Twenty-three cases with AMI were treated intravenously with rt-PA to identify coronary reperfusion and to observe the bleeding rate with clinical phenomenon, ECG and myocardial enzyme activity. Results Senventeen cases got success in reperfusion after intravenous hemothrombolysis, including 11 cases in 6 h and 6 cases in 6-12 h after onset of infarction.Three cases had bleeding complication. Conclusions The rt-PA is effective significantly in 6 h and remains to be effective during 6-12 h after infarction.