小剂量瑞替普酶溶栓疗法治疗老年急性心肌梗死的临床研究

目的 观察小剂量瑞替普酶溶栓疗法治疗老年急性心肌梗死(AMI)的临床效果.方法 将82例老年AMI患者按随机数字表法分为两组,对照组41例采用重组链激酶治疗,观察组41例采用小剂量瑞替普酶治疗,比较两组的临床疗效及溶栓后1、2h冠状动脉再通率.结果 治疗后24h,两组总有效率和病死率比较差异无统计学意义(P＞0.05).观察组溶栓后1、2h冠状动脉再通率均明显高于对照组56.1％(23/41)比26.8％(11/41),63.4％(26/41)比39.0％(16/41)](P＜ 0.05).观察组轻度出血发生率明显高于对照组(P＜0.05),但两组重度出血发生率比较差异无统计学意义(P＞0.05).结论 小剂量瑞替普酶溶栓疗法对老年AMI患者疗效显著,能够为不愿或不能接受冠状动脉成形术的老年患者提供一种安全、有效的治疗方法.

Clinical study of small dose reteplase thrombolytic therapy on old patients with acute myocardial infarction

Objective To observe the effect of small dose reteplase thrombolytic therapy on old patients with acute myocardial infarction(AMI).Methods Eighty-two old patients with AMI were divided into two groups by random digits table,each group had 41 cases.Control group was treated with recombinant streptokinase,and observation group was treated with small dose reteplase.The clinical effect,1 h and 2 h coronary artery recanalization rates between two groups were compared.Results After treatment 24 h,there was no significant difference in total effective rate and death rate between two groups(P＞ 0.05).The 1 h and 2 h coronary artery recanalization rates in observation group were significantly higher than those in control group56.1％(23/41)vs.26.8％(11/41),63.4％(26/41)vs.39.0％(16/41)](P＜ 0.05).The mild bleeding incidence in observation group was significantly higher than that in control group(P ＜ 0.05),while there was no significant difference between two groups in severe bleeding incidence(P ＞ 0.05).Conclusion Small dose reteplase thrombolytic therapy on old patients with AMI is effective,which provide a safe and effective method for elderly patients unwilling or unable to accept the coronary angioplasty.