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目的:观察重组组织型纤溶酶原激活剂(rt-PA)与尿激酶(UK)治疗西宁地区急性心肌梗死(AMI)的疗效。方法:按溶栓药物不同将60例AMI病人随机分为两组。rt-PA组(30例),先给rt-PA 15mg,余量35mg用微量泵于30min内泵入,继以50mg于60min内泵入,特殊情况可适当加量;UK组(30例),将UK150万单位于30min内泵入。结果:rt-PA组血管再通率为80.0%,UK组为53.3%,两组比较差异有显著性(x2=4.800,P<0.05);出血并发症的发生,rt-PA组为10.0%,UK组为13.3%,两组比较无显著性差异(x2=0.16,P>0.05)。住院四周的病死率rt-PA组为6.7%,UK组为10.0%,两组比较无显著性差异(x2=0.22,P>0.05)。结论:西宁地区rt-PA溶栓疗效优于UK,尤其是在患者发病后3h内进行溶栓治疗效果更佳,不增加出血风险,四周住院病死率无增加。
Objective: To observe the effect of recombinant tissue plasminogen activator (rt-PA) and urokinase (UK) on acute myocardial infarction (AMI) in Xining area. Methods: Sixty AMI patients were randomly divided into two groups according to the different thrombolytic drugs. In the rt-PA group (30 cases), rt-PA 15 mg and the remaining 35 mg were pumped within 30 minutes with a micropump, followed by 50 mg within 60 minutes. The patients in the UK group (n = 30) , Will be UK150 million units within 30min pump. Results: The recanalization rate of rt-PA was 80.0% in the rt-PA group and 53.3% in the UK group, with significant difference between the two groups (χ2 = 4.800, P <0.05) , UK group was 13.3%, no significant difference between the two groups (x2 = 0.16, P> 0.05). Survival rates at hospitalization were 6.7% in the rt-PA group and 10.0% in the UK group, with no significant difference between the two groups (x2 = 0.22, P> 0.05). Conclusion: The effect of rt-PA thrombolytic therapy in Xining is better than that of UK. Especially thrombolytic therapy within 3h after onset is better, without increasing the risk of bleeding, and there is no increase in hospitalization mortality in the four weeks.