注射用重组瑞替普酶治疗急性心肌梗死的疗效评价

目的对比观察瑞替普酶(reteplase rPA)与重组组织型纤溶酶原激活剂(rt-PA)用于急性心肌梗死(AMI)溶栓治疗的效果及安全性。方法自2001年11月~2002年5月,共26例AMI患者随机接受rPA或rt-PA溶栓治疗,观察溶栓再通率、急性期死亡率、并发症及不良反应发生率。结果溶栓后2h再通率rPA为92.86%,rt-PA组为75%(P>0.05),90min rPA组3例行冠状动脉造影显示全部再通,rt-PA组3例冠状动造影显示仅1例再通,35d rPA组病死率为14.29%,rt-PA组病死率8.33%(P>0.05),两组各有1例患者发生冠状动脉再闭塞,rt-PA组1例患者发生心力衰竭(P>0.05)。结论rPA为国人治疗AMI安全、有效的溶栓药物。

A parallel randomized controlled study of efficacy of reteplase in patients with acute myocardial infarction

Objective To observe the clinical efficacy of intravenous thrombolytic therapy using reteplase and recombinant tissue-type plasminogen activation(rt-PA) in acute myocardial infarction(AMI).Methods 26 patients with AMI admitted in our department during November 2001 to May 2002,were randomized to receive either reteplase or rt-PA.The patency of infarct-related coronary artery was assessed by unified clinical criteria or angiography.Adverse reactions were also observed.Results 2h after thrombolysis showed no difference rate of patency with reteplase and rt-PA(92.86% vs.75%,P>0.05),There are 3 patients do angiography 90min in each group and reteplase group showed all patients TIMI≥2 but rt-PA group only 1 patient TIMI≥2 (P>0.05).Adverse reactions in 35d showed no difference in each groups.Conclusion Reteplase is an effective,reliable and safe thrombolytic agent in the treatment of acute myocardial infarction.