重组组织型纤溶酶原激活剂与尿激酶溶栓治疗急性心肌梗死的疗效比较

目的：观察小剂量（50mg)重组织型纤维酶原激活剂（rt-PA)与尿激酶（UK）溶栓治疗急性心肌梗死（AMI）的疗效及安全性，方法：将116例AMI患随机分为rt-PA组和UK组，分别应用rt-PA和UK溶栓治疗，结果：冠状动脉（冠脉）总再通率分别rt-PA组80．65％和UK组为51．85％，患在发病后6h内治疗，冠脉再通率分别为rt-PA组91．18％和UK组67．86％，前明显高于后，两组比较均有显差异（P＜0．01），5wk住院病死率分别为rt-PA组6．5％和UK组11．1％，结论：小剂量（50mg)rt-PA用于AMI溶栓治疗的临床疗效明显优于UK，血管再通率高，尤其在发病后6h内进行治疗效果更佳.rt-PA溶栓并发症少,可降低闰 率,是一种安全有效的溶栓剂.

The Efficacy of Thrombolytic Therapy with Recombinant Tissue Plasminogen Activator as Compared with urokinase for Acute Myocardial Infarction

Objective To observe the effect and safety of thrombolytic therapy with low dose recombinant tissue plasminogen activator (rt-PA) as compared with urokinase (UK) for acute myocardial infarction (AMI).Methods 116 patients with AMI were divided into rt-PA group and UK group,which were treated with low dose rt-PA and UK respectively.Results The total reperfusion rate was 80.65% in rt-PA group,and 51.85% in UK group.When thrombolysis was given in 6 hours from symptom onset,the reperfusion rate was significant higher in rt-PA group than that in UK group.(91.18% vs.66.86%).P<0.01.The mortality during 5-week hospitalization was 6.5% (rt-PA group) vs.11.1% (UK group).Conclusions Thrombolytic therapy with low dose (50 mg) rt-PA is significantly more efficacious than that with UK,with higher rate of reperfusion,especially in 6 hours after morbility,and the mortality can be reduced and complications appear to be decreased in rt-PA group.The data above indicates that rt-PA is effective and safe in thrombolytic therapy for acute myocardial infarction.