Objectire This study compares the effects of small dose of recombinant tissue - type plasminogenactivator (tPA) with those of conventional dose of urokinase (UK) and assesses the influence of different modes ofintrave...Objectire This study compares the effects of small dose of recombinant tissue - type plasminogenactivator (tPA) with those of conventional dose of urokinase (UK) and assesses the influence of different modes ofintravenous UK administration in patients with acute myocardial infarction (AMI). Methods Eighty patientswith AMI were randomized to 50mg of tPA (Group Ⅰ, n=26) using an accelerating approach or to 1.0-1.5 millionU of UK (Group Ⅱ, n=54). UK was administered as a single bolus injection of whole dose (GrouP Ⅱa, n=26) orhalf dose bolus injection followed by half dose infusion (Group Ⅱb, n=28). All patients underwent coronaryartsriogrophy 90min after the initiation of intravenous thrombolysis, and the infarct - related coronary artery (IRA)patency was evaluated. Cardiac events during hospitalization were recorded and predischarge left ventricularfunction was determined by two - dimensional echocardiography. Results The IRA patency rate was significantlyhigher in Group Ⅰ (88.4%) than in Group Ⅱ (53.7%) (P<0.01). Group Ⅰ patients had less cardiac events duringhospitalization (11.5% vs 33.3%) and greater improvement in left ventricular function than group Ⅱ patients.However, these angiogrophic, left ventricular functional and prognostic parameters did not significantly differbetween Group Ⅱa and Group Ⅱb. Conclusion Thrombolysis after AMI with small dose of intravenous tPAexerts better angiographic and clinical effects than that with conventional dose of UK. The thrombolytic effects ofUK were not affected by different modes of intravenous administration of the agent.展开更多
文摘Objectire This study compares the effects of small dose of recombinant tissue - type plasminogenactivator (tPA) with those of conventional dose of urokinase (UK) and assesses the influence of different modes ofintravenous UK administration in patients with acute myocardial infarction (AMI). Methods Eighty patientswith AMI were randomized to 50mg of tPA (Group Ⅰ, n=26) using an accelerating approach or to 1.0-1.5 millionU of UK (Group Ⅱ, n=54). UK was administered as a single bolus injection of whole dose (GrouP Ⅱa, n=26) orhalf dose bolus injection followed by half dose infusion (Group Ⅱb, n=28). All patients underwent coronaryartsriogrophy 90min after the initiation of intravenous thrombolysis, and the infarct - related coronary artery (IRA)patency was evaluated. Cardiac events during hospitalization were recorded and predischarge left ventricularfunction was determined by two - dimensional echocardiography. Results The IRA patency rate was significantlyhigher in Group Ⅰ (88.4%) than in Group Ⅱ (53.7%) (P<0.01). Group Ⅰ patients had less cardiac events duringhospitalization (11.5% vs 33.3%) and greater improvement in left ventricular function than group Ⅱ patients.However, these angiogrophic, left ventricular functional and prognostic parameters did not significantly differbetween Group Ⅱa and Group Ⅱb. Conclusion Thrombolysis after AMI with small dose of intravenous tPAexerts better angiographic and clinical effects than that with conventional dose of UK. The thrombolytic effects ofUK were not affected by different modes of intravenous administration of the agent.
