不同剂量重组组织型纤溶酶原激活剂溶栓治疗急性心肌梗死的疗效评价

目的比较50rag和100mg重组组织型纤溶酶原激活剂（rt—PA）溶栓治疗急性心肌梗死疗效的差别。方法入选78例急性心肌梗死患者，其中50mg组35例，100mg组43例。两组患者都常规应用阿司匹林和肝素等药物，分别静脉注射重组组织型纤溶酶原激活剂（rt—PA）50mg和100mg。比较两组患者溶栓后的冠状动脉开通率（根据临床判定），发病30d左室射血分数和死亡率。结果冠状动脉开通率50mg组为77．1％（27例），100mg组为81．4％（35例）；30d左室射血分数分别为（48．7±7．2）％，（50．0±7．6）％；30d病死率分别为5．7％（2例），4．7％（2例），两组间比较均无统计学意义。结论100mg和50mg重组组织型纤溶酶原激活剂（rt—PA）对于国人急性心肌梗死的溶栓疗效相似。

Evaluation of the therapeutic effect of thrombolytic therapy with rt-PA in patients with acute myocardial infarction

Objective To compare the effect of 50mg dose rt-PA with that of 100mg dose rt-PA in patients with acute myocardial infarction （AMI）. Methods Of 78 AMI patients enrolled in this study, 35 patients received 50mg rt-PA and the remaining 43 patients received 100mg rt-PA. All patients simultaneously received routine aspirin and heparin. The ob- servational endpoint included the reperfusion rate of the infarct-related artery （assessed clinically）, left ventricular ejection fraction and mortality within 30 days. Results Reperfusion was diagnosed in 27 patients of the 50mg group and in 35 patients of the 100mg group. There were no significant differences in the reperfusion rate, left ventricular ejection fraction and 30-day mortality between the two groups. Conclusions The effect of 50mg and 100mg rt-PA is similar in AMI patients.