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目的探讨小剂量(50 mg)重组组织型纤溶酶原激活剂(recombinant tissue-type plasminogen activa-tor,rt-PA)30 min、60 min 与90 min 等3种给药方法治疗急性心肌梗死(AMI)对心电图 ST 段变化的影响。方法244例 AMI 患者随机分为 rt-PA 50mg、30min 方案组49例(A 组),60min 方案组76例(B 组)与90min 方案组119例(C 组)。比较3组患者在不同时间的 ST 段回降率。结果溶栓60 min 时,A 组 ST 段回降率均高于 B 组(P<0.05)和 C 组(P<0.01);90 min 时,B 组 ST 段回降率均高于 A 组和 C 组(P<0.05);120 min 时,C 组 ST 段回降率均高于 A 组和 B 组(P<0.05)。结论小剂量 rt-PA 30 min、60 min 给药法可使心电图抬高的 ST 段早期回落,促进心肌早期再灌注。
Objective To investigate the effects of low dose (50 mg) recombinant tissue-type plasminogen activa-tor (rt-PA) for 30 min, 60 min and 90 min on acute myocardial infarction AMI) on ECG ST segment changes. Methods 244 patients with AMI were randomly divided into rt-PA 50mg group, 49 patients in the 30min group (group A), 76 patients in the 60min group (group B) and 119 patients in the 90min group (group C). The ST-segment drop rates of the three groups were compared at different time points. Results The descending rate of ST segment in group A at 60 min after thrombolysis was significantly higher than that in group B (P <0.05) and group C (P <0.01). At 90 min, the descending rate of ST segment in group B was higher than that of group A C group (P <0.05). At 120 min, the ST-segment descending rate in group C was higher than those in group A and group B (P <0.05). Conclusion Low-dose rt-PA 30 min, 60 min administration can make ECG ST elevation early fall, promote myocardial reperfusion early.