国产重组人组织型纤溶酶原激酶衍生物临床应用疗效观察  

Effects of Recombinant Human Tissue Type Plasminogen Kinase Derivative Clinical Efficacy Observation

作　　者：刘忠芬[1] 高桂敏[1] 曲海虎[1] 

机构地区：[1]章丘市人民医院急诊科,山东章丘250200

出　　处：《医学信息》2013年第1期59-60,共2页Journal of Medical Information

摘　　要：目的观察重组人组织型纤溶酶原激酶衍生物（ReteplaseforInjection，rPA）在急性sT段抬高型心肌梗死、血栓栓塞症、治疗中的临床疗效和不良反应。方法所有患者应用rPA前均静脉推注肝素2000U。急性ST段抬高型心肌梗死患者继以小剂量重组人组织型纤溶酶原激酶衍生物即rpA18mg溶于10ml生理盐水中，于5min内静脉注入，30min后重复rPA18nag，然后续以双联（氯比格雷十阿司匹林）强化抗血小板治疗及低分子肝素抗凝治疗：血栓栓塞症患者继以重组人组织型纤溶酶原激酶衍生物即rPA18mg溶于100ml盐水中，于30in内静脉注入，少数患者30min后重复1次．然后予以低分子肝素、酌情加用华法林序贯抗凝治疗；观察血管再通率、不良反应发生率及病死率。结果再通率100％，出血率3.2％，排除2例溶栓前华法林服用者，出血的发生率为不到2％。结论重组人组织型纤溶酶原激酶衍生物（ReteplaseforIniection，rPA）高效、安全，值得临床大力推广。Objective To evaluate the efficacy and safety of the Reteplase for Injection in patients with acute st -segment elevation myocardial infarction （ASTEMI）, deep venous thrnmbosis （DVT）-acute puhnnnary embolism （PE）. Methods All patients were treated with heparin 2000u intravenious injection before thrombolysis.To the patients with acute st -segment elevation myocardial infarction,18mg rPA dissolved to the 10 ml physiology brines is seconded by intravenious injection within 5minute, repeated it in 30minute , then ,the enhanced double antiplatelet agent （clopidogrel and aspirin enteric-coated tablets） and low molecular weight heparin （LMWH） agent is gived; To the patients with deep venous thrombosis （DVT）-acute pulmonary embolism （PE） , 18mg rPA dissolved to the 100 ml physiology brines is seconded by intravenious drip within 30minute, repeated it in 30minute pro re nata , then , low molecular weight heparin （LMWH） agent is gived, warfarin is gived pro re nata ; the observed targets are the vascular reopen rate, bad reaction incidence rate and mortality rate. Results the vascular reopen rate lead to 100%, the bleeding rate leads to 3.2% , expel 2 patients raked warfarin in advance, the bleeding rate doesn,t reach 2%.Conclusion Reteplase for Injection（rPA） is efficiently, safetly, it worth clinical dew）ted major efforts to expand.

关 键 词：急性ST段抬高型心肌梗死 血栓栓塞症 组组织型纤维蛋白溶酶原激活剂 溶栓治疗 

分 类 号：R362[医药卫生—病理学]