瑞替普酶溶栓治疗急性心肌梗死的疗效观察  

Observation of Therapeutic Effect of Reteplace for Acute Myocardial Infarction

作　　者：刘帆[1] 黄新平[1] 孙琳[1] 李慧娟[1] 杨红玲[1] 何亚磊[1] 

机构地区：[1]大理学院昆明附属医院心内科,昆明650011

出　　处：《大理学院学报（综合版）》2009年第6期27-28,36,共3页Journal of Dali University

摘　　要：目的:研究ST段抬高的急性心肌梗死(STEMI)发病后不同时间溶栓的疗效和不良反应。方法:对86例住院的STEMI患者用瑞替普酶行溶栓治疗,依据发病到溶栓开始的时间将86例患者分为三组:A组≤lh(n=28),B组>1h,但<6h(n=36),C组>6h,但≤12h(n=22),观察梗塞相关动脉(IRA)的开通率、5周病死率和溶栓副作用。结果:IRA开通率:A组92.9%(26/28),B组86.1%(31/36),C组45.5%(10/22),C组与A、B两组差异性显著(P<0.01),A、B两组间无显著性差异(P>0.05)。病死率:A组、B组和C组的5周病死率分别为0%(0/28),2.77%(1/36)和4.54%(1/22),A、B两组间无显著性差异〔0%(0/28)vs 2.77%(1/36),P>0.05〕,A组与C组有显著性差异〔0%(0/28)vs 4.54%(1/22),P<0.01〕,B组与C组有显著性差异〔2.77%(1/36)vs 4.54%(1/22),P<0.01〕,三组中均无包括脑出血在内的重大出血并发症。结论:瑞替普酶溶栓治疗STEMI疗效好、安全性高。objective： To evaluate the efficacy and side effects of thrombolytic therapy on the patients with STEMI in different times after the onset of symptoms. Methods： 86 patients receiving venous thrombolysis with Reteplase were divided into three groups, according to the time of the onset of symptoms： Group A〈1h （n=28）; Group B 1-6h （n=36）： Group C〉6h, but ≤ 12h （n=22）. Results： The reperfusion rates of IRA were： Group A was 92.9%（26/28）, group B was 86.1% （31/36）, and group C was 45.5%（ 10/ 22）. Significant difference existed between group C and group A and B （P〈0.01）. No significant difference existed between group A and group B （P〉0.05） Mortality rates in 5 weeks were 0%（0/28 ）, 2.77%（1/36） and 4.54%（ 1/22 ） for group A, B and C respectively. No significant difference existed between group A and group B [0%（0/28） vs 2.77%（1/36）, P〉0.05]. Significant differences existed between group A and group C [0%（0/28） vs 4.54%（ 1/22）,P〈0.011, but with significant differences between group B and group C [2.77%（1/36） vs 4.54%（1/22）,P〈0.01]. No severe hemorrhagy occurred in three groups. Conclusion： Thrombolytic therapy with Reteplase on the patients was safe and effective.

关 键 词：急性心肌梗死 瑞替普酶 溶栓治疗 开通率 病死率 

分 类 号：R242.22[医药卫生—中医临床基础]