替奈普酶在急诊冠状动脉介入治疗中冠脉内溶栓治疗的效果及安全性  

Efficacy and Safety of Teneplase in Intra-coronary Thrombolysis during Emergency Percutaneous Coronary Intervention

作　　者：张河南 ZHANG Henan(Department of Cardiovascular Internal Medicine,Tianzhu County People's Hospital,Qiandongnan Miao and Dong Autonomous Prefecture,Guizhou,556699,China)

机构地区：[1]天柱县人民医院心血管内科,贵州黔东南556699

出　　处：《中外医疗》2025年第3期58-62,共5页China & Foreign Medical Treatment

摘　　要：目的 分析替奈普酶在急诊冠状动脉介入治疗(percutaneous coronary intervention,PCI)中冠脉内溶栓治疗效果及安全性。方法 随机选取2022年2月—2023年8月天柱县人民医院收治的80例急性心肌梗死急诊PCI患者为研究对象,按照不同治疗方法分为两组,每组40例。观察组使用替奈普酶冠脉内溶栓治疗,对照组使用阿替普酶冠脉内溶栓治疗,比较两组冠脉内溶栓再通率、无复流/慢复流情况、心肌损伤情况、心功能、出血发生率。结果 观察组冠脉内溶栓再通率、无复流/慢复流率均优于对照组,差异均有统计学意义(P均<0.05)。治疗后,观察组心肌肌钙蛋白I低于对照组,差异有统计学意义(P<0.05)。两组肌酸激酶同工酶指标比较,差异无统计学意义(P>0.05)。两组患者治疗后的心排血指数、舒张早期充盈峰速度、左室射血分数水平较治疗前明显升高,差异均有统计学意义(P均<0.05),但组间比较差异无统计学意义(P>0.05)。观察组总出血率为5.00%(2/40),低于对照组的20.00%(8/40),差异有统计学意义(χ^(2)=4.114,P=0.043)。结论 替奈普酶在PCI中冠脉内溶栓治疗效果较高,与阿替普酶相当,可以改善心肌灌注,但更利于减轻心肌损伤和减少出血风险,安全性更高。Objective To analyze the efficacy and safety of teneplase in intra-coronary thrombolysis during emergency coronary intervention(PCI).Methods A total of 80 patients with acute myocardial infarction who underwent emer-gency PCI in Tianzhu County People's Hospital from February 2022 to August 2023 were randomly selected as the re-search objects.They were divided into two groups according to different treatment methods,with 40 cases in each group.The observation group was treated with intracoronary thrombolysis with tenecteplase,while the control group was treated with intracoronary thrombolysis with alteplase.The recanalization rate of intracoronary thrombolysis,no-reflow/slow-reflow,mycardial injury status,cardiac function and incidence of bleeding were compared between the two groups.Results The recanalization rate of intracoronary thrombolysis and no reflow/slow reflow in the observation group were better than those in the control group,and the differences were statistically significant(both P<0.05).After treatment,the cardiac troponin I in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in creatine kinase isoenzyme level between the two groups(P>0.05).The cardiac index,early diastolic filling peak velocity and left ventricular ejection fraction of the two groups after treatment were significantly higher than those before treatment,and the differences were statisti-cally significant(all P<0.05),but there were no significant differences between the two groups(all P>0.05).The inci-dence of bleeding in the observation group was 5.00%(2/40),which was lower than 20.00%(8/40)in the control group,and the difference was statistically significant(χ^(2)=4.114,P=0.043).Conclusion Teneplase has higher efficacy in intra-coronary thrombolytic therapy during PCI,comparable to alteplase,which can improve myocardial perfusion,but is more conducive to reducing myocardial injury and bleeding risk,with higher safety.

关 键 词：急性心肌梗死 冠状动脉介入治疗 替奈普酶 溶栓 

分 类 号：R541[医药卫生—心血管疾病]