重组型纤溶酶原激活剂与尿激酶在急性心肌梗死溶栓治疗中的比较

目的比较小剂量重组型纤溶酶原激活剂（rt-PA）与尿激酶（UK）溶栓治疗急性心肌梗死（AMI）的疗效和安全性。方法回顾42例接受rt-PA和49例接受UK溶栓治疗的AMI患者病例资料，对结果进行比较分析。结果冠脉总再通率rt-PA组和UK组分别为85．71％和61．22％（P〈0．05）；患者在发病3h和3—12h内溶栓，冠脉再通率在rt-PA组为94．11％和80．00％（P〉0．05），在UK组为70．00％和58．97％（P〉0．05）；出血并发症rt．PA组和UK组分别为9．52％和10．20％（P〉0．05）。结论rt-PA的溶栓冠脉再通率显著高于UK，并且两组在发病后3h内较3h后溶栓均能取得更高的冠脉再通率，但无统计学差异。

Comparison of recombinant tissue plasminogen activator and urokinase in thrombolytic therapy of acute myocardial infarction

Objective To evaluate the efficacy and safety of recombinant tissue plasminogen activator （rt - PA） and urokinase （UK） in the thrornbolytic therapy of acute myocardial infarction （AMI）. Methods The cliriical data of 91 AMI patients who underwent intravenous thrombolysis with rt - PA （n = 42）or UK （n = 49）were retrospectively analyzed and compared. Results Significant difference was found in coronary total recanalization rate between rt - PA and UK group （85.71% vs 61.22% ,P 〈0.05）. In rt - PA group,the recanalization rate of thrombolytic therapy within 3 hours and from 3 to 12 hours after onset of AMI were 94.11% and 80.00% ,respectively （P 〉0.05）. Similarly,there was no significant difference in the recanalization rate between thrombolysis within 3 hours and beyond in UK group （70.00% vs 58.97% ,P 〉 0.05 ）. The incidence of bleeding complication was similar between the two groups （ 9.52% vs 10.20%, P 〉 0.05 ）. Conclusion The coronary recanalization rate in rt - PA group is significantly higher than that in UK group. In both groups, the recanalization rate of thrombolysis within 3 hours after onset of AMI appears to increase slightly compared with that over 3 hours, but the difference has no statistical significance.