常规剂量替罗非班联合半剂量瑞替普酶对急性STEMI的疗效  

Thrombolytic effect of routine dose tirofiban combined half dose reteplase on acute STEMI

作　　者：王庭学[1] 吴国平[2] 梁毓源 

机构地区：[1]海南省琼海市人民医院急诊科,海南琼海571400 [2]海南医学院附属医院急诊科 [3]海南省琼海市人民医院心内科,海南琼海571400

出　　处：《心血管康复医学杂志》2016年第3期308-311,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨常规剂量替罗非班联合半剂量瑞替普酶对急性ST段抬高型心肌梗死(STEMI)的溶栓效果与安全性。方法:选择2013年3月至2015年3月我院收治的经冠状动脉造影确诊为急性STEMI的患者112例。患者被随机均分为瑞替普酶组(仅接受常规剂量瑞替普酶治疗)和联合治疗组(接受常规剂量替罗非班联合半剂量瑞替普酶治疗)。观察比较两组患者溶栓治疗30min、60min和120 min后的梗死血管再通率和出血并发症发生率。结果:与瑞替普酶组比较,溶栓治疗30min、60min和120 min后,联合治疗组梗死血管再通率(30min:7.1%比25.0%,60min:26.8%比51.8%,120min:60.7%比82.1%)显著升高,P<0.05或<0.01。联合治疗组和瑞替普酶组均未出现颅内出血和泌尿道出血病例,且消化道出血(8.9%比7.1%)、牙龈出血(12.5%比8.9%)以及出血总发生率(21.4%比16.1%)均无显著差异,P均>0.05。结论:与常规剂量瑞替普酶治疗比较,常规剂量替罗非班联合半剂量瑞替普酶治疗急性ST段抬高型心肌梗死的溶栓效果更显著,且安全性等同瑞替普酶。Objective:To explore thrombolytic effect of routine dose tirofiban combined half dose reteplase on acute ST segment elevation myocardial infarction(STEMI)and its safety.Methods:A total of 112 patients who were diagnosed as acute STEMI through coronary angiography in our hospital from Mar 2013 to Mar 2015 were selected.They were randomly and equally divided into reteplase group(only received routine dose reteplase treatment)and combined treatment group(received routine dose tirofiban combined half dose reteplase treatment).Infarct vessel recanalization rate on 30 min,60min and 120 min after thrombolytic therapy and incidence rate of hemorrhage complications were observed and compared between two groups.Results:Compared with reteplase group on 30,60 and 120min after thrombolytic treatment,there were significant rise in infarct vessel recanalization rate(30min:7.1% vs.25.0%,60min:26.8% vs.51.8%,120min:60.7% vs.82.1%)in combined treatment group,P<0.05 or <0.01.No intracranial hemorrhage and urinary tract bleeding occurred in both groups,and there were no significant difference in incidence rates of gastrointestinal bleeding(8.9% vs.7.1%),gingival bleeding(12.5% vs.8.9%)and total incidence rate of bleeding(21.4% vs.16.1%)between two groups,P>0.05 all.Conclusion:Compared with routine dose reteplase treatment,routine dose tirofiban combined half dose reteplase possesses more significant thrombolytic effect in patients with acute STEMI,and the safety is still good as reteplace.

关 键 词：心肌梗死 替罗非班 瑞替普酶 

分 类 号：R542.22[医药卫生—心血管疾病]