发病2h内ST段抬高型急性心肌梗死患者重组链激酶溶栓的临床价值  

Clinical Value of Recombinant Streptokinase for ST-segment Elevation Acute Myocardial Infarction Thrombolysis with Disease Onset Less than 2 h

作　　者：唐瑞双 邢佳侬 刘小凤[1] 戚秀娟 陈晓君[2] 

机构地区：[1]唐山市第三医院心内科,河北唐山063100 [2]开滦(集团)有限责任公司唐家庄医院心内科

出　　处：《华南国防医学杂志》2014年第10期973-975,共3页Military Medical Journal of South China

摘　　要：目的研究ST段抬高型急性心肌梗死(ST-segment elevation acute myocardial infarction,STEMI)患者在发病2h内使用重组链激酶溶栓的临床价值。方法将作者医院2010-01/2012-12月收治的110例STEMI患者作为研究对象,随机分为治疗组和对照组,每组各55例;治疗组在发病2 h内使用重组链激酶溶栓;对照组在发病4 h使用重组链激酶溶栓。比较两组患者溶栓时间、ST段回落时间以及胸痛缓解情况;记录两组患者治疗前后的肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)含量并进行比较;记录两组患者治疗后的治愈率、并发症发生情况以及再梗死率,并进行比较。结果治疗组的溶栓时间、ST段回落时间,胸痛评分均明显优于对照组(t=34.6221,127.0219,13.3492;P=0.0000);治疗后,两组患者的CK、CK-MB水平均明显下降;治疗组上述指标改善程度明显优于对照组(t=3.8037,6.3747;P<0.01);治疗组治愈率为92.73%,高于对照组的70.91%;治疗组并发症共2例,占3.64%,低于对照组的16.36%;治疗组再梗死率为5.45%,低于对照组的20.00%(P<0.05)。结论 STEMI患者应在发病后,2 h内使用重组链激酶溶栓,具有较好的疗效,溶栓时间短,ST段回落快,治愈率高。Objective To analyse the clinical value of recombinant streptokinase for ST segment elevation acute myocardial infarction patients with disease onset less than2 h.Methods A total of 110 patients with acute ST segment elevation myocardial infarction patients from our hospital in January to December in2012 were randomly divided into treatment group and control group,with55 cases each.The treatment group was treated with recombinant streptokinase within2 h after the disease onset while the control group within4 h.Time,ST segment resolution time and pain relief situation were compared between two groups.The creatine kinase and creatine kinase isoenzyme contentand before and after treatment of two groups patients were recorded and compared,too.Results Time of thrombolysis,down time of ST period and pain score of treatment group were significantly better than those of the control group（t=34.6221,127.0219,13.3492;P=0.0000）.After treatment,creatine kinase,creatine kinase isoenzyme levels decreased in both groups significantly and the condition was significantly better in the treatment group than the control group（t=3.8037,6.3747;P〈0.01）.The cure rate of treatment group was 92.73%,which was higher than 70.91% of the control group.Two cases in the treatment group had complications（3.64%）,which was lower than16.36% of the control group.Reinfarction rate of the treatment group was 5.45%,which was lower than 20% of the control group.Conclusion Thrombolytic therapy with recombinant streptokinase within2 h after disease onset has good curative effect for patients with ST segment elevation acute myocardial infarction.It takes short time for the thrombolysis in ST segment resolution and has high cure rate.

关 键 词：ST段抬高 急性心梗 重组链激酶 溶栓 

分 类 号：R542.22[医药卫生—心血管疾病]