应用瑞替普酶溶栓治疗急性心肌梗死的临床研究  

Clinical research on thrombolytic therapy of reteplase for acute myocardial infarction

作　　者：郝志敏[1] 卢冬喜 郝玉静[1] 王峥[1] 赵立华[1] 

机构地区：[1]承德医学院附属医院心内科,河北承德067000 [2]秦皇岛市人民医院,河北秦皇岛066000

出　　处：《四川医学》2009年第8期1222-1224,共3页Sichuan Medical Journal

摘　　要：目的观察瑞替普酶(r-PA)静脉溶栓治疗急性心肌梗死(AMI)的临床疗效及安全性。方法符合入选标准的80例患者随机分为治疗组(40例)和对照组(40例),治疗组给予瑞替普酶10mU+10mU静脉溶栓治疗方案:对照组给予阿替普酶静脉溶栓治疗,观察临床症状,溶栓后2h内部分活化凝血酶原时间(APTT)和EF值,2周内发生休克、心力衰竭、心律失常、脑卒中、缺血复发及再梗死、死亡的发生率作为复合临床终点,出血并发症及过敏反应等。结果治疗组临床疗效、胸痛症状缓解率及再通率明显改善;治疗组部分活化凝血酶原时间延长,但与对照组比较差异无统计学意义(P>0.05),EF值高于对照组(P<0.05);治疗组AIVR、全部心律失常的发生率与对照组比较差异无统计学意义(P>0.05),治疗组严重心律失常的发生率高于对照组(P<0.05);治疗组复合临床事件发生率低于对照组(P<0.05);两组均未出现重度或致命性出血及过敏反应。结论临床上应用瑞替普酶溶栓治疗急性心肌梗死是安全、有效的。Objective To evaluate the efficacy and safety of reteplase for the treatment of acute myocardial infarction （AMI）. Methods 80 patients were randomly divided into treatment group （40 cases） and control group （40 cases）, treatment group was treated with 10mU＋10mU intravenous thrombolytic therapy and the control group was treated with alteplase, and then observed clinical symptoms, thrombolysis within 2h APTT and EF value, occurred in 2 weeks shock, heart failure, cardiac ar- rhythmia, stroke, recurrent ischemia and re-infarction, the incidence of death as a composite clinical endpoints, such as bleeding complications and allergic reactions. Results The clinical efficacy in the treatment group, chest pain and symptom remission rate of recanalization rate improved; extension of the APTT, but compared with the control group was no significant difference （P〉 0. 05）, EF values higher （P〈O. 05 ） ; in the treatment group, the AIVR and all of the incidence of arrhythmia compared with the control group there was no significant difference （ P〉O. 05 ）, the incidence of serious arrhythmias in the treatment group was high- er than the control group （ P〈0. 05 ） ; composite clinical events in the treatment group was lower than the control group （ P〈 0. 05） ; the two groups did not appear severe or fatal bleeding and allergic reactions. Concluson Thrombolytic therapy of rete- plase for acute myocardial infarction is safe and effective.

关 键 词：急性心肌梗死 溶栓疗法 瑞替普酶 阿替普酶 

分 类 号：R542.22[医药卫生—心血管疾病]