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目的 评价小剂量重组组织型纤溶酶原激活物 (r-TPA)与国产重组链激酶 (r-SK)治疗急性心肌梗死 (AMI)的疗效 ,并比较二者的差异。方法 71例AMI患者 ,均采用静脉溶栓 ,随机分为r -TPA治疗组 (36例 )和r-SK治疗组 (35例 )。结果 梗死相关血管再通率r-TPA组为 77 78% (2 8/ 36 ) ,r-SK组为 74 2 9% (2 6 / 35 ) ,P >0 0 5 ,差异不显著 ;4周病死率r-TPA组为 5 5 6 % (2 / 36 ) ,r-SK组为 5 71(2 / 35 ) % ,差异不显著 (P >0 0 5 ) ;两组均未出现严重出血。但r-SK组过敏反应发生率为 8 5 7% (3/ 35 ) ,低血压发生率为 2 86 % (1/ 35 )。结论 加速法使用国产r -SK治疗AMI,梗死相关血管再通率、4周病死率r-TPA与r-SK相似 ,但过敏反应及低血压发生率r-SK较r-TPA高 ,国产r-SK治疗AMI安全有效 ,无严重出血 ,费用较r-TPA低 ,值得临床推广使用。
Objective To evaluate the efficacy of low dose recombinant tissue plasminogen activator (r-TPA) and domestic recombinant streptokinase (r-SK) in the treatment of acute myocardial infarction (AMI), and to compare the differences. Methods 71 AMI patients were treated with intravenous thrombolysis and were randomly divided into r-TPA treatment group (36 cases) and r-SK treatment group (35 cases). Results The infarct-related vascular recanalization rate was 77 78% (28/36) in the r-TPA group and 74 2 9% (26/35) in the r-SK group, with no significant difference at 4 weeks The mortality rate was 56.6% (2/36) in r-TPA group and 5 71 (2/35)% in r-SK group, with no significant difference (P> 0.05). No severe bleeding occurred in both groups. However, the incidence of allergic reaction in r-SK group was 85.7% (3/35) and the incidence of hypotension was 286% (1/35). Conclusion Acceleration of domestic r-SR treatment of AMI, infarction-related vascular recanalization rate, 4-week mortality r-TPA and r-SK similar, but the incidence of allergic reactions and hypotension r-SK high r-TPA, domestic r -SK treatment of AMI safe and effective, no severe bleeding, the cost is lower than the r-TPA, it is worth promoting the use of the clinic.