重组型纤溶酶原激活剂与尿激酶在急性心肌梗死溶栓中的比较  

Comparison of recombinant tissue-type plasminogen activator and urokinase in acute myocardial infarction

作　　者：杨勇填[1] 李炳流[1] 江慧琳[1] 林珮仪[1] 李燕屏[1] 陈晓辉[1] 

机构地区：[1]广州医学院第二附属医院急诊科,广东广州510260

出　　处：《中国急救医学》2006年第11期814-816,共3页Chinese Journal of Critical Care Medicine

基　　金：2005年广州科技攻关项目(No.2005Z3-E0361);2004年广州市高校科技计划项目(No.1054)

摘　　要：目的比较重组型纤溶酶原激活剂(rt-PA)和尿激酶(UK)对急性心肌梗死(AMI)溶栓的效果和不良反应。方法对我院AMI接受溶栓治疗患者回顾性分析,每组各30例,一组予70～100 mg rt-PA溶栓,另一组予150万U UK溶栓治疗,统计两组溶栓再通率、不良反应发生率。其中48例择期行冠脉造影,以判定冠脉是否再通,同时与临床再通的指标进行比较。结果溶栓再通率rt-PA组为86．7%,UK组为63．3%,两组比较有统计学意义(P＜0．05)；不良反应两组比较无统计学意义(P＞0．05)；临床再通率与造影再通率正相关(r=0．90)。结论溶栓再通率rt-PA高于UK；判断临床再通率与造影再通率差异无统计学意义(P＞0．05),在没有冠脉造影的条件下,临床指标仍然是判定冠脉再通的有效指征。Objective To observe and compare the clinical efficacy and adverse reaction of recombinant tissue - type plas- minogen activator （ rt - PA） and urokinase （ UK） in acute myocardial infarction （ AMI）. Methods 60 AMI patients with thrombolytic therapy were retrospectively analyzed. 30 patients were treated by rt - PA （70 - 100 mg） and the others were treated by UK （ 1.5 MU ）. Percentage of reperfusion, mortality and adverse reaction rate were recorded. Coronary angiography was carried out and compared with clinical indexes for evaluating coronary recanalization. Results The reperfusion rate of rt - PA group was 86.7% and UK group 63.3% （ P 〈0.05 ） respectively. There were no significant differences in adverse reaction between rt - PA group and UK group （ P 〉 0.05 ）. Rate of coronary recanalization evaluated by clinical indexes and that evaluated by coronan, angiography were positive correlation （ r = 0. 90）. Conclusion The reperfusion rate in rt - PA group is higher than that in UK. There were no significant differences between the reperfusion rate of clinical and that of coronary angiography（ P 〉0.05）. The clinical indexes are still valid for estimating coronary reperfusion without coronary angiography.

关 键 词：心肌梗死 重组型纤溶酶原激活剂 尿激酶 血栓溶解疗法 冠脉造影 

分 类 号：R542.22[医药卫生—心血管疾病]