低分子肝素联合阿替普酶治疗ST段抬高型急性心肌梗死患者的有效性和安全性研究

目的探讨低分子肝素联合阿替普酶治疗ST段抬高型急性心肌梗死(STEAMI)的疗效和安全性。方法将我院心内科住院的120名ST段抬高型急性心肌梗死患者随机分为试验组和对照组,各60例,两组溶栓治疗均选用阿替普酶,之后试验组予低分子肝素5000U皮下注射,2次/d;对照组予普通肝素静脉滴注,24h后改为低分子肝素皮下注射,2次/d,观察两组间在临床再通率、血管再通率及并发症等方面的差别。结果试验组予对照组间在临床再通率、血管再通率中有差异,但差异无统计学意义(P>0.05);但试验组出血率明显低于对照组,差异有统计学意义(P<0.05);两组间病死率、再灌注心律失常发生率差异不明显,无统计学意义(P>0.05)。结论低分子肝素联合阿替普酶治疗ST段抬高型急性心肌梗死疗效好、安全性高。

Research on Efficacy and Safety of Low Molecular Weight Heparin Combined with Alteplase on the Treatment of Patients with Acute Myocardial Infarction of ST Segment Elevation

Objective To observe the efficacy and safety of low molecular weight heparin combined with alteplase to treat acute myocardial infarction of ST segment elevation.Methods 120 patients with acute myocardial infarction of ST segment elevation treated hospitalized in department of Cardiology in our hospital were selected randomly into 2 groups,the experiment group and the control group,each group for 60 cases.Thrombolytic therapy of 2 groups all applied alteplase,and the experiment group were given subcutaneous injection of low molecular weight heparin of 5000U,2 /d.The control group were given unfractionated heparin infusion,and changed into subcutaneous injection of low molecular weight heparin,2/d.Observing the difference of clinical patency rate,recanalization rate and complications of 2 groups.Results There was difference between 2 groups as for clinical patency rate,recanalization rate and complications,and the difference had no statistical significance（P0.05）.Bleeding rate of the experiment group was lower evidently than that of the control group,which had statistical significance（P0.05）.There was no evident difference between 2 groups as for fatality rate and Reperfusion arrhythmia,which had no statistical significance（P0.05）.Conclusions Low molecular weight heparin combined with alteplase on the treatment of patients with acute myocardial infarction of ST segment elevation has the advantages of good curative effect and high security.