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目的应用链激酶（ＳＫ）、重组链激酶（ｒ－ＳＫ）、尿激酶（ＵＫ）、重组组织型纤溶酶原激活物（ｒｔ－ＰＡ）溶栓治疗急性心肌梗死（ＡＭＩ）患者，比较其凝血与纤溶系统的动态变化。方法对４３例经溶栓治疗（ＳＫ８例，ｒ－ＳＫ１３例，ＵＫ１６例，ｒｔ－ＰＡ６例）的ＡＭＩ患者，分别于溶栓前后动态检测凝血酶原时间（ＰＴ）、活化的部分凝血活酶时间（ＡＰＴＴ）、纤维蛋白原（ＦＧ）、Ｄ二聚体（Ｄ－Ｄｉｍｅｒ）、纤溶酶原（ＰＬＧ）、α２抗纤溶酶（α２ＡＰ）、组织型纤溶酶原激活物（ｔ－ＰＡ）、组织型纤溶酶原激活物抑制物（ＰＡＩ－１）等指标的活性或含量。结果应用ＳＫ、ｒ－ＳＫ、ＵＫ、ｒｔ－ＰＡ溶栓治疗后，均会引起凝血活性的明显降低与纤溶活性的明显增高。ＳＫ与ｒ－ＳＫ对凝血与纤溶系统的影响略高于ＵＫ。ｒｔ－ＰＡ对ＦＧ含量影响低于另外３者（Ｐ值均＜００５）。结论凝血与纤溶活性的变化与溶栓疗效关系密切
Objective To investigate the effect of thrombolytic therapy on patients with acute myocardial infarction (AMI) by streptokinase (SK), recombinant streptokinase (r-SK), urokinase (UK) and recombinant tissue plasminogen activator (rt-PA) Dynamic changes of coagulation and fibrinolysis system. Methods Thirty-three patients with AMI who underwent thrombolytic therapy (SK 8, r-SK 13, UK 16, and rt-PA 6) underwent thrombin time (PT) and activated partial thromboplastin (APTT), fibrinogen (FG), D-dimer, PLG, α2AP, t- PA), tissue plasminogen activator inhibitor (PAI-1) and other indicators of the activity or content. Results After thrombolysis with SK, r-SK, UK and rt-PA, both the coagulation activity and the fibrinolytic activity were significantly increased. The effect of SK and r-SK on the coagulation and fibrinolytic system was slightly higher than that of UK. The effect of rt-PA on FG content was lower than that of the other three groups (all P <005). Conclusion The changes of coagulation and fibrinolytic activity are closely related to the effect of thrombolysis