rt-PA溶栓治疗急性心肌梗死的效果  

EFFECT OF RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR IN THE TREATMENT OF ACUTE MYOCARDIAL INFARCTION

作　　者：山峰[1] 孟军[1] 周长勇[1] 

机构地区：[1]青岛大学医学院附属医院急症科,青岛266003

出　　处：《齐鲁医学杂志》2000年第4期238-240,共3页Medical Journal of Qilu

摘　　要：1目的　观察应用重组组织型纤溶酶原激活剂 (rt- PA )溶栓治疗急性心肌梗死 (AMI)的效果。 2方法　按溶栓药物不同将 94例 AMI病人分为 2组。rt- PA组 (5 5例 )先给负荷量 rt- PA 10～ 15 mg,余量 35～ 40 m g用微量泵于 30 min内泵入 ,继以 5 0 mg于 6 0 min内泵入 ,特殊情况可适当加量。尿酸氧化酶 (U K)组 (39例 )将 UK 15 0万单位于 30 m in内泵入 ,肝素不作常规应用。 3结果　 rt- PA组血管再通率为 80 .0 % ,UK组为 5 6 .4% ,两组间比较差异有显著性 (χ2 =6 .0 7,P<0 .0 5 )。 rt- PA组再灌注性心律失常发生率为 6 5 .5 % ,UK组为 43.6 % ,两组间比较亦有显著差异 (χ2 =4.44 ,P<0 .0 5 )。 rt- PA组和 UK组轻度出血发生率分别为 12 .7%和 17.9% ,住院 30 d的病死率分别为 1.8%和 7.7% ,两组间比较差异均无显著性 (χ2 =0 .49,1.93,P>0 .0 5 )。 4结论　 rt- PA是治疗 AMI的一种安全、有效的纤溶剂 。Objective\ To observe the effect of recombinant tissue plasminogen activator(rt PA) in the treatment of acute myocardial infarction(AMI).\ Methods\ Ninty four patients with AMI were divided into two groups according to different thrombolytic drugs used. rt PA group(55 patients): a load dose of rt PA 10-15mg was given before pumping the remaining dose of 35-40mg by micropump in 30 minutes and then pumping 50mg in 60 minutes. The dose of rt PA might be increased in special cases. UK group(39 patients): 1.5 million units of UK were pumped in 30 minutes while heparin was not used routinely.\ Results The reperfusion rates were 80.0% and 56.4% in rt PA group and UK group, respectively. The difference was significant between the two groups( χ 2=6.07, P <0.05). The occurrence rate of reperfusional arrhythmias was 65.5% in rt PA group and 43.6% in UK group, there was significant difference between the two groups( χ 2=4.44, P <0.05). Mild bleeding occurred in 12.7% and 17.9% ,respectively. The mortality of inpatients during 30 days was 1.8% and 7.7% in rt PA group and UK group, respectively, no significance between the two groups.\ Conclusion\ rt PA is a safe and effective drug, the effectiveness is directly interrelated with the time that the thrombolytic therapy begins. [

关 键 词：急性心肌梗死 溶栓疗法 RT-PA AMI 

分 类 号：R542.220.5[医药卫生—心血管疾病]