急性心肌梗死的溶栓治疗与缺血再灌注损伤

目的观察重组链激酶与尿激酶治疗急性心肌梗死(AMI)的疗效、副作用及缺血再灌注损伤.方法81例符合溶栓治疗标准的AMI患者分为重组链激酶(r-sk)组和尿激酶(uk)组,按AMI溶栓治疗参考方案给予溶栓治疗,观察其血管再通率、出血副作用和缺血再灌注损伤.结果r-sk组血管总再通率高于uk组,发病6 h内血管再通率高于uk组;两组出血副作用发生率相近;r-sk组缺血再灌注损伤发生率为66.7%,uk组为69.0%,但r-sk组严重缺血再灌注损伤发生率低于uk组.结论r-sk治疗AMI安全有效,血管再通率高于uk,缺血再灌注损伤发生率与uk相近,但严重缺血再灌注损伤发生率低于uk.

Thrombolytic therapy of acute myocardial infarction and the ischemia-reperfusion injury

Objective:To observe the therapeutic effect,side effects and ischemia-reperfusion injury of the thrombolytic therapy treated with recombinant streptokinase or with urokinase.Methods:81AMI patients suitable for thrombolytic therapy were randomly divided into r-sk group and uk group.Thrombolytic treatment was applied according to the project of AMI thrombolytic therapy and the recanalization rate,side effects,and the incidence of ischemia-reperfusion injury were observed.Results:The reperfusion rate of r-sk group was higher than that of uk group;the total recanalization rate within6hours was higher than that of uk group;the rate of hemorrhage was similar between two groups;The rate of ischemia-reperfusion injury was66.7%in r-sk group and69.0%in uk group,but the rate of severe ischemia-reperfusion was lower in r-sk group compared with uk group.Conclusions:The treatment with r-sk was safe and effective,and the recanalization rate was higher compared with uk and the rate of severe ischemia-reperfusion of r-sk was lower compared with uk group.