摘要
目的比较瑞替普酶和尿激酶治疗急性心肌梗死的疗效,并探讨早期应用瑞替普酶在基层医院中的可行性及其深远意义。方法选取本院2016年5月至2018年5月收治的急性ST段抬高型心肌梗死患者240例作为观察对象,依据随机数字表法分为观察组和对照组,各120例。观察组应用瑞替普酶进行溶栓治疗,对照组应用尿激酶进行溶栓治疗,统计并对比两组血管再通率、死亡率、心血管事件发生率。结果溶栓30 min两组血管再通率对比差异无统计学意义;溶栓60 min观察组血管再通率显著高于对照组,差异有统计学意义(P<0.05);溶栓90 min观察组血管再通率显著高于对照组,差异有统计学意义(P<0.05);溶栓120 min观察组血管再通率显著高于对照组,差异有统计学意义(P<0.05)。两组心血管事件发生率对比差异无统计学意义。观察组出血率显著低于对照组,差异有统计学意义(P<0.05)。观察组死亡率显著低于对照组,差异有统计学意义(P<0.05)。结论在急性心肌梗死早期溶栓治疗中瑞替普酶的疗效显著优于尿激酶,其可有效促进罪犯血管再通,减少临床死亡和出血,尤其适用于不能开展急诊冠状动脉介入术的基层医院。
Objective To compare the efficacy of reteplase and urokinase in early thrombolytic therapy of acute myocardial infarction.And explore the feasibility and far-reaching significance of early application of reteplase in primary hospitals.Methods 240 patients with acute ST-segment elevation myocardial infarction admitted from May 2016 to May 2018 were randomly divided into experimental group(n=120)and control group(n=120).Urokinase was used for thrombolytic therapy in the control group and reteplase was used for thrombolytic therapy in the experimental group.The recanalization rate,mortality and incidence of cardiovascular events were compared between the two groups.Results There was no significant difference in vascular recanalization rate between the two groups at 30 minutes,Experimental group was significantly higher than that in the control group at 60 minutes(P<0.05),and higher than that in the control group at 90 minutes(P<0.05).The recanalization rate of blood vessels in the experimental group was significantly higher than that in the control group at 120 minutes(P<0.05).There was no significant difference in the incidence of cardiovascular events between the two groups.The bleeding rate in the experimental group was significantly lower than that in the control group(P<0.05).The mortality rate in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion In the early stage of thrombolytic therapy of acute myocardial infarction,the effect of reteplase is better than that of urokinase,which can effectively promote the recanalization of blood vessels and reduce clinical death and bleeding.It is especially suitable for primary hospitals that cannot perform percutaneous coronary intervention.
作者
冯源海
朱晓彤
张瑜
郑小鹏
韩红梅
万红丽
刘梦宇
赵日宁
田丰
Feng Yuanhai;Zhu Xiaotong;Zhang Yu;Zheng Xiaopeng;Han Hongmei;Wan Hongli;Liu Mengyu;Zhao Rining;Tian Feng(Department of Cardiology,Xing'an League People's Hospital,Ulanhot,Inner Mongolia,137400,China)
出处
《当代医学》
2019年第28期11-13,共3页
Contemporary Medicine
关键词
急性心肌梗死
早期溶栓治疗
瑞替普酶
尿激酶
基层医院
Acute myocardial infarction
Early thrombolytic therapy
Reteplase
Urokinase
Primary hospitals
