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急性心肌梗塞后早期冠脉血栓溶解,可能引起严重心律失常,这已被动物实验和临床研究结果所证实,特别是不完全性再灌注。本文报告重组组织型纤溶酶原激活剂Alteplase治疗中的室性心律失常。 309例拟诊急性心肌梗塞,在症状开始5小时内随机给予Alteplase(158例)或安慰剂(151例),并作24小时动态心电图监测。Altep1ase静滴剂量为100mg,3小时滴完。结果发现,溶栓组中室性心律失常(包括室速)人数多于安慰剂组(P<0.05);溶栓组的心律失常主要集中于4～12小时,12小时后逐渐减少。1个月后,共死亡18例,溶栓
Early acute coronary thrombolysis after acute myocardial infarction may cause severe arrhythmia, which has been confirmed by animal experiments and clinical studies, especially incomplete reperfusion. This article reports the ventricular arrhythmia in the treatment of recombinant tissue-type plasminogen activator Alteplase. A total of 309 patients with acute myocardial infarction (MI) were randomized to receive Alteplase (158 patients) or placebo (151 patients) within 5 hours of symptom onset and monitored for 24-hour Holter monitoring. Altep1ase intravenous infusion dose of 100mg, 3 hours drip finished. The results showed that there were more ventricular arrhythmias (including ventricular tachycardia) in the thrombolytic group than in the placebo group (P <0.05). The arrhythmia in the thrombolytic group was mainly concentrated in 4 to 12 hours and gradually decreased after 12 hours. After 1 month, a total of 18 patients died of thrombolysis