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  

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

作　　者：肖建强[1] 何国平[1] 季建国[1] 钱亿超[1] 周惠芬[1] 

机构地区：[1]江苏大学附属武进医院心内科,江苏常州213002

出　　处：《西南国防医药》2010年第3期252-254,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：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3 h和3～12 h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3 h内较3 h后溶栓均能取得更高的冠脉再通率,但无统计学差异。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.

关 键 词：心肌梗死 重组型纤溶酶原激活剂 尿激酶 溶栓 

分 类 号：R541.4[医药卫生—心血管疾病]