HTUPA溶栓治疗急性ST段抬高心肌梗死的临床疗效  

Clinical efficacy of HTUPA for thrombolysis therapy in acute ST - segment elevated myo - cardial infarction

作　　者：刘明新[1] 陶贵周[1] 王守力[1] 高航[1] 王高频[1] 

机构地区：[1]辽宁医学院附属第一医院心内科,辽宁锦州121001

出　　处：《中国急救医学》2012年第12期1117-1120,共4页Chinese Journal of Critical Care Medicine

基　　金：辽宁省医学高峰建设工程项目（2010075）

摘　　要：目的评价人组织尿激酶型纤溶酶原激活剂（HTUPA）静脉溶栓治疗急性sT段抬高心肌梗死（STEMI）的临床疗效与安全性。方法选择符合诊断标准的急性STEMI患者40例，随机分为HTUPA组与重组人组织型纤溶酶原激活剂（rt-PA）组进行溶栓治疗（每组20例）。药物溶栓后监测实验室指标并行冠状动脉造影和心脏彩超检查，观察两种药物溶栓治疗后的梗死相关血管的再通率、心功能变化及不良事件，评价HTUPA疗效及安全性。结果HTUPA组与rt-PA组的一般临床资料比较差异无统计学意义（P〉0．05）；rt-PA组与HTUPA组经冠状动脉造影证实的梗死相关血管再通率分别为80．0％和85．0％；两组出血率分别为35．0％和25．0％，两组在改善心功能方面差异无统计学意义（P〉0．05）。两组均有轻度出血发生，无严重不良并发症发生，rt-PA组有1例消化道出血。两种溶栓药物对肾功能、血清离子等没有造成不良影响。结论①HTUPA静脉溶栓治疗急性STEMI与rt-PA比较具有同等效果的梗死相关血管再通率。②HTUPA静脉溶栓治疗急性STEMI与rt-PA比较不增加出血事件，两种溶栓药物对心功能改善效果一样。③HTUPA用法简便，优于rt-PA，不需要持续静脉给药。Objective To evaluate the efficacy and safety of Human tissue urokinase plasminogen activior （ HTUPA ） for thrombolysis therapy of acute ST - segment elevated myocardial infarction（STEMI） by comparison with Recombinant tissue- type tissue plasminogen activator（ rt- PA）. Methods Forty patients who meet the experimental criteria and were randomly divided into the HTUPA group （20 cases） and the rt -PA group （20 cases）. After thrombolysis therapy, To evaluate the efficacy and safety of HTUPA for thrombolysis therapy of acute ST - segment elevation myocardial infarction （STEMI）, we can investigate the laboratory parameters, adverse events, coronary angiography （CAG） and echocardiography to obtain the infarction related artery （IRA） pateney rate and the changes of heart function. Results There were no significant difference of general clinical feature （ age, sex, weight, diabetes, hypertension, ete） between the two groups; it was proved that the reperfusion rate of HTUPA group was 85.0% , rt - PA group was 80.0% by coronary angiography （ CAG）, showing no obvious difference. Both of the two groups showed mild bleeding and had no serious adverse complications, rt - PA group had a case of gastrointestinal bleeding, The bleeding rate of HTUPA group was 25.0%, the rt - PA group was 35.0%. Statistical analysis shows the two groups have no significant difference to improve the cardiac function. There were no adverse effects of the two thrombolytic drugs onthe aspect of kidney function and serum ions. Conclusion ①HTUPA is proved to be as effective as rt - PA for ASTEMI in the infarction related artery patency rate. ②HTUPA for thrombolysis therapy of ASTEMI by comparison with recombinant tissue - type tissue plasminogen activator dose not increase the bleeding events, and has no difference in improvement of cardiac function.③HTUPA is a thrombolytic medicine which is used easily and doesnt need continuous infusion.

关 键 词：人组织尿激酶型纤溶酶原激活剂(HTUPA) 重组人组织型纤溶酶原激活剂(rt—PA) 溶栓 急性 ST段抬高心肌梗死(STEMI) 

分 类 号：R542.220.5[医药卫生—心血管疾病]