重组组织型纤溶酶原激活物与尿激酶静脉溶栓治疗急性心肌梗死疗效比较

目的：观察小剂量（５０ｍｇ）重组组织型纤溶酶原激活物（ｒｔＰＡ）与尿激酶（ＵＫ）静脉溶栓治疗急性心肌梗死的疗效。方法：将患者随机分为ｒｔＰＡ和ＵＫ２组进行对比研究。结果：ｒｔＰＡ组冠状动脉（冠脉）总再通率为７５．０％，ＵＫ组冠脉总再通率为６１．３％。患者在发病＜３小时溶栓治疗，ｒｔＰＡ组冠脉再通率为８６．７％，ＵＫ组冠脉再通率为６６．７％，前者明显高于后者，但统计学处理尚无显著性差异（Ｐ＞０．０５），原因与例数较少有关；住院并发症和预后２组结果无明显差异，但平均ＣＣＵ时间和平均住院时间前者〔（７．１±１．２）日和（２２．５±６．１）日〕较后者〔（１１．７±３．１）日和（２７．３±７．３）日〕明显减少（Ｐ均＜０．０５）。结论：小剂量（５０ｍｇ）ｒｔＰＡ有良好的溶栓效果，冠脉再通率高，尤其在发病后３小时内进行治疗效果更佳；ｒｔＰＡ溶栓无出血不良反应发生，并能显著缩短患者平均住院时间。

The efficacy of thrombolysis with recombinant tissue plas minogen activator as compared with urokinase for acute myocardial infarction

Objective :To observe the effectiveness of thrombolytic therapy with recombinant tissue plasminogen activator (rt PA) as compared with urokinase for acute myocardial infarction (AMI). Methods :Patients with AMI were divided into two groups,which were treated with either 50 mg of rt PA or 1520 million units of urokinase. Results :28 patients were included in rt PA group,and 31 patients in urokinase group.The reperfusion rate was 750% in rt PA group ,and 613% in urokinase group.When the time from symptom onset to thrombolysis was shorter than 3 hours,the reperfusion rate in rtD2PA group was higher than that in urokinase group (867% vs.667%,P>005).Although there was no significant difference in the complications during hospitalization and prognosis,a significant reduction in the time of CCU and mean hospital days in rt PA group were observed compared with urokinase group (7112)days vs.(11731)days;(22561)days vs.(27373)days,both P<005. Conclusions :These data indicate that thrombolytic therapy with 50 CLC number: R543.3105 Document code: A Artical ID: 1003 0603(1999)07 0389 03 mg of rt PA is significantly more efficaceous,especially when given in less than 3 hours from symptom onset to thrombolysis.Complications appear to be rare,and no bleeding complcation is seen in rt PA group.Moreover,patients treated with rt PA have significantly shorter hospital stay.