摘要
目的比较瑞替普酶与尿激素在急性ST段抬高型心肌梗死(STEMI)溶栓治疗中的临床效果。方法选取2017年2月-2019年12月福建省三明市第一医院收治的急性STEMI患者168例,按照均等单盲法将患者随机分为研究组和对照组,每组84例。2组患者均溶栓治疗,研究组溶栓药物为瑞替普酶,对照组溶栓药物为尿激酶。比较2组的临床效果和安全性。结果研究组溶栓治疗0.5、1、1.5 h和2 h血管再通率均高于对照组,差异均有统计学意义(P<0.05)。研究组ST段回落>70%和ST段回落50%~70%的占比高于对照组,而ST段回落<50%的占比低于对照组,差异均有统计学意义(P<0.05)。研究组溶栓再通时间短于对照组,肌酸激酶(CK)峰值和肌酸激酶同工酶(CK-MB)峰值低于对照组,差异均有统计学意义(P<0.01)。研究组心血管事件总发生率为9.52%,低于对照组的22.62%,差异有统计学意义(χ^(2)=5.340,P=0.021)。结论与尿激酶比较,急性STEMI患者的溶栓治疗中采用瑞替普酶可提高溶栓成功率,减少心血管事件的发生率,保障患者治疗的安全性,临床应用价值显著。
Objective To compare the clinical effect of reteplase and urinary hormone in thrombolytic therapy of acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 168 patients with acute STEMI admitted to Sanming First Hospital of Fujian Province from February 2017 to December 2019 were selected.According to the equal singleblind method,the patients were divided into study group and control group,with 84 patients in each group.Patients in both groups received thrombolytic therapy,the thrombolytic drug used in the study group was reteplase,and the thrombolytic drug used in the control group was urokinase.Compared the clinical efficacy and safety of the two groups.Results The revascularization rates of thrombolysis at 0.5,1,1.5 h and 2 h in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).The proportion of ST segment regression>70%and ST segment regression 50%to 70%in the study group were higher than that in the control group,while the proportion of ST segment regression<50%was lower than that in the control group,the differences were statistically significant(P<0.05).The time of thrombolytic recanalization in the study group was shorter than that in the control group,and the peak values of creatine kinase(CK)and creatine kinase isoenzyme(CK-MB)were lower than those in the control group,the differences were statistically significant(P<0.01).The overall incidence of cardiovascular events in the study group was 9.52%,lower than that in the control group(22.62%),and the difference was statistically significant(χ^(2)=5.340,P=0.021).Conclusion Compared with urokinase,the use of reteplase in thrombolytic therapy for acute STEMI patients can improve the success rate of thrombolytic therapy,reduce the occurrence of cardiovascular events,ensure the safety of treatment for patients,and has significant clinical application value.
作者
陈英金
柯俊
陈锋
CHEN Yingjin;KE Jun;CHEN Feng(Department of Intensive Care Medicine,Sanming First Hospital,Fujian Province,Sanming 365000,China;不详)
出处
《临床合理用药杂志》
2022年第1期7-10,共4页
Chinese Journal of Clinical Rational Drug Use
基金
2018年福建省科技厅引导性项目(No:2018Y0009)。
关键词
急性ST段抬高型心肌梗死
溶栓治疗
瑞替普酶
尿激酶
治疗效果
安全性
Acute ST-segment elevation myocardial infarction
Thrombolytic therapy
Reteplase
Urokinase
Therapeutic effect
Security
