尿激酶与重组织型纤溶酶原激活剂静脉溶栓治疗急性心肌梗死

目的观察重组织型纤溶酶原激活剂(rt-PA)与尿激酶(UK)溶栓治疗急性心肌梗死的疗效及安全性。方法89例AMI患者,rt-PA静脉溶栓治疗35例(其中包括剂量为50mg 15例,剂量为100mg 20例),UK组54例,观察临床疗效。结果rt-PA组梗死相关血管(IRA)的再通率为71.43%,UK组为37.04%,两组有显著性差异(P<0.01)。rt-PA组左室射血分数(LVEF)为51.7%,UK组为48.6%,,两组无显著性差异(P>0.05)。rt-PA 50 mg组IRA的再通率为53.3%,100 mg组的再通率为80%,两组无显著性差异。两组LVEF、梗死后心绞痛发生率均无显著性差异(P>0.05)。结论rt-PA溶栓效果优于UK,而rt-PA 50 mg和100mg疗效相似。

Comparison of thrombolytic therapy with recombinant tissue plasminogen activator and urokinase for acute myocardial infarction

Objective To observe the effect and safety of thrombolytic therapy with recombinant tissue plasminogen activator(rt-PA)group as compared with urokinase(UK) for acute myocardial infarction(AMI).Methods Eighty-nine patients with AMI were divided into rt-PA group and UK group,which were treated with rt-PA(including 50mg and 100mg group) and UK respectively.Results The total reperfusion rate of infarct-related artery(IRA) was 71.43% in rt-PA group,and 37.04% in UK group(P<0.05).The left ventricular ejection fraction was higher in the rt-PA group compared with UK(51.7% vs 48.6%),but there were no significant differences between two groups(P>0.05).The reperfusion rate of 50mg rt-PA group was lower than that in 100 mg rt-PA group(53.3% vs 80%),but there was no statistical significance.There were no significant differences between 50 mg and 100 mg rt-PA groups in postinfarction angina pectoris rate and LVEF.Conclusion rt-PA is more effective than that of UK in thrombolytic therapy for AMI.Low dose(50mg) rt-PA is as effective as 100mg rt-PA.