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目的：观察小剂量（５０ｍｇ）重组组织型纤溶酶原激活物（ｒｔＰＡ）与尿激酶（ＵＫ）静脉溶栓治疗急性心肌梗死的疗效。方法：将患者随机分为ｒｔＰＡ和ＵＫ２组进行对比研究。结果：ｒｔＰＡ组冠状动脉（冠脉）总再通率为７５．０％，ＵＫ组冠脉总再通率为６１．３％。患者在发病＜３小时溶栓治疗，ｒｔＰＡ组冠脉再通率为８６．７％，ＵＫ组冠脉再通率为６６．７％，前者明显高于后者，但统计学处理尚无显著性差异（Ｐ＞０．０５），原因与例数较少有关；住院并发症和预后２组结果无明显差异，但平均ＣＣＵ时间和平均住院时间前者〔（７．１±１．２）日和（２２．５±６．１）日〕较后者〔（１１．７±３．１）日和（２７．３±７．３）日〕明显减少（Ｐ均＜０．０５）。结论：小剂量（５０ｍｇ）ｒｔＰＡ有良好的溶栓效果，冠脉再通率高，尤其在发病后３小时内进行治疗效果更佳；ｒｔＰＡ溶栓无出血不良反应发生，并能显著缩短患者平均住院时间。
Objective: To observe the curative effect of intravenous thrombolytic therapy with low dose (50mg) recombinant tissue plasminogen activator (rtPA) and urokinase (UK) on acute myocardial infarction. Methods: The patients were randomly divided into rtPA and UK2 group for comparative study. Results: The total recanalization rate of coronary artery was 75.0% in rtPA group and 61.3% in UK group. Thrombolytic therapy in patients with onset <3 hours, rtPA coronary recanalization rate was 86.7%, UK coronary artery recanalization rate was 66.7%, the former was significantly higher than the latter, but no significant statistical treatment (P> 0.05). The reason was related to the small number of cases. There was no significant difference between the two groups in hospital complications and prognosis, but the mean CCU time and average length of hospital stay were (7.1 ± 1.2) days And (22.5 ± 6.1) days than those in the latter 〔(11.7 ± 3.1) days〕 and (27.3 ± 7.3 days〕 (P <0.05). Conclusion: The low dose (50mg) of rtPA has a good thrombolytic effect, high rate of coronary recanalization, especially within 3 hours after the onset of treatment is better; rtPA thrombolysis without bleeding adverse reactions, and can significantly shorten the average patient Hospitalization time.