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目的探讨基层医院急性ST段抬高型心肌梗死(STEMI)溶栓疗法中不同溶栓剂的选择和应用。方法 90例STEMI患者随机分为A组和B组各45例,A组采用瑞替普酶治疗,B组采用尿激酶溶栓治疗,比较两组的疗效及安全性。结果与B组比较,A组血管再通率较高(88.9%vs 71.1%,P<0.05),特别是发病时间>6 h者(66.7%vs 12.5%P<0.05);A组出院前左心室射血分数(LVEF)较高,脑钠肽(BNP)较低(P<0.05),心功能较好。两组均无致死性大出血及脑出血。结论瑞替普酶能早期快速开通梗死相关血管,减少心肌损伤,改善心功能和预后,是STEMI患者的更佳选择。
Objective To investigate the selection and application of different thrombolytic agents in acute STEMI thrombolytic therapy in primary hospitals. Methods 90 STEMI patients were randomly divided into group A and group B, 45 cases each. Group A received reteplase and group B received urokinase thrombolysis. The curative effect and safety of the two groups were compared. Results Compared with group B, the recanalization rate in group A was higher (88.9% vs 71.1%, P <0.05), especially in patients with onset time> 6 h (66.7% vs 12.5%, P <0.05) Higher ventricular ejection fraction (LVEF), lower BNP (P <0.05) and better cardiac function. No fatal bleeding and cerebral hemorrhage occurred in both groups. Conclusion Reteplase can rapidly open infarct-related blood vessels early, reduce myocardial injury, improve cardiac function and prognosis, which is a better choice for STEMI patients.